Provider Demographics
NPI:1265872394
Name:STRONG, DOMINIQUE COURTNEY (DC)
Entity type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:COURTNEY
Last Name:STRONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4638
Mailing Address - Country:US
Mailing Address - Phone:920-734-4016
Mailing Address - Fax:920-734-4086
Practice Address - Street 1:1426 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4638
Practice Address - Country:US
Practice Address - Phone:920-734-4016
Practice Address - Fax:920-734-4086
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4944-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor