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Contact Information

CRAIG A COUILLARD, DC
9202 202ND ST W
SUITE 203
LAKEVILLE, MN55044-7915
 Phone: 952-469-8385
 Fax: 952-469-1713
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for CRAIG A COUILLARD · (Male)

NPI # 1497741185
Status Active
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 09/27/2005
Last updated 09/06/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 3955
  • MN Medicaid 727678800
  • MN Other 411991603 FEDERAL TAX ID #
  • MN Other 350002308 MEDICAR PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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