Provider Demographics
NPI:1700065836
Name:CREGGER, MICHAEL L (LAC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:CREGGER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3714 BEALE AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-1302
Mailing Address - Country:US
Mailing Address - Phone:814-569-5997
Mailing Address - Fax:
Practice Address - Street 1:3714 BEALE AVE
Practice Address - Street 2:STE 200
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-1302
Practice Address - Country:US
Practice Address - Phone:814-569-5997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO 000536171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist