Provider Demographics
NPI:1093905366
Name:TRESNICKY, MICHAEL (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:TRESNICKY
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 1:5401 NETHERBY LN STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7363
Mailing Address - Country:US
Mailing Address - Phone:843-767-0080
Mailing Address - Fax:843-767-0030
Practice Address - Street 1:5401 NETHERBY LN STE 201
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7363
Practice Address - Country:US
Practice Address - Phone:843-767-0080
Practice Address - Fax:843-767-0030
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC260618649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor