Healthcare Provider Details

I. General information

NPI: 1477653251
Provider Name (Legal Business Name): CRONIN CHIROPRACTIC AND ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 ELLISBORO RD SUITE L
STOKESDALE NC
27357-9208
US

IV. Provider business mailing address

PO BOX 506
STOKESDALE NC
27357-0506
US

V. Phone/Fax

Practice location:
  • Phone: 336-643-3850
  • Fax:
Mailing address:
  • Phone: 336-643-3850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number915
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number915
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number915
License Number StateNC

VIII. Authorized Official

Name: DR. DENNIS PATRICK CRONIN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 336-643-3850