Provider Demographics
NPI:1831240365
Name:GARRONE, CYNTHIA J (DC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:J
Last Name:GARRONE
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 1:310 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:MI
Mailing Address - Zip Code:49098-9346
Mailing Address - Country:US
Mailing Address - Phone:269-463-3436
Mailing Address - Fax:269-463-6004
Practice Address - Street 1:310 LEWIS ST
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:MI
Practice Address - Zip Code:49098-9346
Practice Address - Country:US
Practice Address - Phone:269-463-3436
Practice Address - Fax:269-463-6004
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11276722OtherCAQH PROVIDER ID
MI11276722OtherCAQH PROVIDER ID