Provider Demographics
NPI:1174759021
Name:KRENEK, MICHELLE LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYNN
Last Name:KRENEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21518 BLANCO RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-3381
Mailing Address - Country:US
Mailing Address - Phone:254-541-6158
Mailing Address - Fax:210-579-2382
Practice Address - Street 1:21518 BLANCO RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-3381
Practice Address - Country:US
Practice Address - Phone:254-541-6158
Practice Address - Fax:210-579-2382
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor