Craig Alan Ravenscroft, D.C.

Individual provider Active NPI Chiropractor · Frazier Park, CA

NPI 1093730541 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1093730541
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
DC 21102 (CA)
Practice address
3402 Mt Pinos Way
Frazier Park, CA 93225
Phone
(661) 245-3456
Fax
(661) 245-1200
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DC 21102CAMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 21102 CA Yes

Addresses

Primary practice location

3402 Mt Pinos Way
Frazier Park, CA 93225

Mailing address

PO Box 1500
Frazier Park, CA 93225-1500
Phone (661) 245-3456

Other providers in Frazier Park, CA

All providers in Frazier Park, CA · Chiropractor in California

Sources for this page

Verify at the official NPI Registry.