Provider Demographics
NPI:1659383537
Name:TENCKHOFF, CARL FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:FRANK
Last Name:TENCKHOFF
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 1:173 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3324
Mailing Address - Country:US
Mailing Address - Phone:530-899-2699
Mailing Address - Fax:530-899-2903
Practice Address - Street 1:173 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3324
Practice Address - Country:US
Practice Address - Phone:530-899-2699
Practice Address - Fax:530-899-2903
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17799Medicare UPIN
CADC0145110Medicare ID - Type Unspecified