Provider Demographics
NPI:1386677888
Name:RONCHETTI, CHRISTINA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:RONCHETTI
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 1:414 N 75TH ST
Mailing Address - Street 2:APT 4
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3575
Mailing Address - Country:US
Mailing Address - Phone:608-931-1013
Mailing Address - Fax:
Practice Address - Street 1:732 N JACKSON ST
Practice Address - Street 2:SUITE 150
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4620
Practice Address - Country:US
Practice Address - Phone:414-272-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3906-012111N00000X
MA2436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38863200Medicaid
WI000335180Medicare ID - Type Unspecified