Provider Demographics
NPI:1417179938
Name:CHRENCIK, CHARLES FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANK
Last Name:CHRENCIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:FRANK
Other - Last Name:CHRENCIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:22767 HIGHWAY 25
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:AL
Mailing Address - Zip Code:35051-3529
Mailing Address - Country:US
Mailing Address - Phone:205-669-5252
Mailing Address - Fax:
Practice Address - Street 1:22767 HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:AL
Practice Address - Zip Code:35051-3529
Practice Address - Country:US
Practice Address - Phone:205-669-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor