Provider Demographics
NPI:1548567977
Name:KRENZKE, CATHERINE A (PTA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:KRENZKE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 S PINECROFT LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-8374
Mailing Address - Country:US
Mailing Address - Phone:989-839-8572
Mailing Address - Fax:
Practice Address - Street 1:929 S PINECROFT LN
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-8374
Practice Address - Country:US
Practice Address - Phone:989-839-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1712615225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant