Provider Demographics
NPI:1801110895
Name:BRUMMERT, CRAIG D (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:BRUMMERT
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:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-1530
Mailing Address - Country:US
Mailing Address - Phone:907-443-7477
Mailing Address - Fax:907-443-7487
Practice Address - Street 1:113 E FRONT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-9800
Practice Address - Country:US
Practice Address - Phone:907-443-7477
Practice Address - Fax:907-443-7487
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor