Provider Demographics
NPI:1891787883
Name:KRENZKE, JAMES PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:KRENZKE
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:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MN
Mailing Address - Zip Code:55943-0756
Mailing Address - Country:US
Mailing Address - Phone:507-896-2227
Mailing Address - Fax:
Practice Address - Street 1:212 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MN
Practice Address - Zip Code:55943
Practice Address - Country:US
Practice Address - Phone:507-896-2227
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN002040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN39430-KROtherBCBS