Provider Demographics
NPI:1447640396
Name:HENRY, CRAIG (BOCO, BOCPED)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:BOCO, BOCPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 WOODROW DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8207
Mailing Address - Country:US
Mailing Address - Phone:970-372-1273
Mailing Address - Fax:
Practice Address - Street 1:7208 WOODROW DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:970-372-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist