MEDICARE: DR. DEREK C STRONG D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4791-012	WI
2	111N00000X	Chiropractor	11718	TX

General Provider Information

NPI Number	:	1093096323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK C STRONG D.C.

Provider Business Mailing Address
First Line	:	715 W PARKWAY BLVD STE C
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54914-2645
Country	:	US
Telephone Number	:	920-734-4016
Fax Number	:	920-734-4086

Provider Business Practice Location Address
First Line	:	1801 N RICHMOND ST
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54911-2730
Country	:	US
Telephone Number	:	920-831-4110
Fax Number	:	920-734-4086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2011
Last Update Date	:	09/05/2025

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