Individual
DR. CRAIG MICHAEL PETITGOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
850 22ND AVE # 3, CORALVILLE, IA 52241-1565
(319) 354-9574
(319) 834-1128
Mailing address
850 22ND AVE # 3, CORALVILLE, IA 52241-1565
(319) 354-9574
(319) 834-1128
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A06076
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160606
—
IA
Enumeration date
07/10/2006
Last updated
11/14/2007
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