Provider Demographics
NPI:1255471835
Name:ALTON J. KRENZELOK D C P C
Entity Type:Organization
Organization Name:ALTON J. KRENZELOK D C P C
Other - Org Name:AVENUES HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALTON
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KRENZELOK
Authorized Official - Suffix:
Authorized Official - Credentials:D C P C
Authorized Official - Phone:307-433-8853
Mailing Address - Street 1:520 RANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-2774
Mailing Address - Country:US
Mailing Address - Phone:307-433-8853
Mailing Address - Fax:307-433-8854
Practice Address - Street 1:520 RANDALL AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-2774
Practice Address - Country:US
Practice Address - Phone:307-433-8853
Practice Address - Fax:307-433-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty