Provider Demographics
NPI:1912290024
Name:CONSIGLIO, ANTHONY WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:CONSIGLIO
Suffix:
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 1:20960 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48174-9319
Mailing Address - Country:US
Mailing Address - Phone:734-479-2363
Mailing Address - Fax:734-479-2360
Practice Address - Street 1:20960 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48174-9319
Practice Address - Country:US
Practice Address - Phone:734-479-2363
Practice Address - Fax:734-479-2360
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor