Provider Demographics
NPI:1376969782
Name:CRAIN, ROSS DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:DAVID
Last Name:CRAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2940 65TH ST E
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-2040
Mailing Address - Country:US
Mailing Address - Phone:651-451-1012
Mailing Address - Fax:651-453-1543
Practice Address - Street 1:683 BIELENBERG DR STE 103
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1711
Practice Address - Country:US
Practice Address - Phone:651-731-0505
Practice Address - Fax:651-731-0500
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor