Provider Demographics
NPI:1154918662
Name:CONSIGLIO, JOANNA MARIE (DC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARIE
Last Name:CONSIGLIO
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 1:6525 BRECKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4855
Mailing Address - Country:US
Mailing Address - Phone:216-573-2600
Mailing Address - Fax:216-573-1933
Practice Address - Street 1:6525 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-4855
Practice Address - Country:US
Practice Address - Phone:216-573-2600
Practice Address - Fax:216-573-1933
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor