| Doctor Name: | MR. CRAIG BERRY |
| NPI Number: | 1093043101 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 41733700 |
| Business Practice Address: | 920 Lamplighter Ln Grafton, WI - 530249314 |
| Business Phone Number: | 2625731657 |
| Business Fax Number: | |
| Mailing Address: | 920 Lamplighter Ln, GRAFTON |
| State: | WI |
| Postal Code: | 530249314 |
| Phone Number: | 2625731657 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2009 |
| NPI Last Update Date: | 12/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 41733700 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |