Provider Demographics
NPI:1437038312
Name:CRISWELL, CAL (DC)
Entity type:Individual
Prefix:DR
First Name:CAL
Middle Name:
Last Name:CRISWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 EAGLE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5575
Mailing Address - Country:US
Mailing Address - Phone:678-919-7788
Mailing Address - Fax:
Practice Address - Street 1:2990 EAGLE DR STE 102
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5575
Practice Address - Country:US
Practice Address - Phone:678-919-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO066548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor