Provider Demographics
NPI:1477876134
Name:CRONINGER, MICHAEL JOSEPH JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:CRONINGER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 W SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-4015
Mailing Address - Country:US
Mailing Address - Phone:920-420-5796
Mailing Address - Fax:
Practice Address - Street 1:4070 W SPENCER ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-4015
Practice Address - Country:US
Practice Address - Phone:920-731-3255
Practice Address - Fax:920-731-3357
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4552-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor