Provider Demographics
NPI:1578990792
Name:KRENZELOK, DANIEL J (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:KRENZELOK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 S PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-7506
Mailing Address - Country:US
Mailing Address - Phone:715-726-1631
Mailing Address - Fax:715-726-1587
Practice Address - Street 1:2677 S PRAIRIE VIEW RD
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-7506
Practice Address - Country:US
Practice Address - Phone:715-726-1631
Practice Address - Fax:715-726-1587
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9027-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist