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NPI Code Detail

MEDICARE: JUSTIN KRENK

MEDICARE: JUSTIN KRENK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1568934115
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN KRENK
Provider Business Mailing Address
First Line : 7540 NEW WEST RD
Second Line :
City : TOLEDO
State : OH
Zip : 43617-4200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7540 NEW WEST RD
Second Line :
City : TOLEDO
State : OH
Zip : 43617-4200
Country : US
Telephone Number : 866-203-0308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2018
Last Update Date : 12/20/2018

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Directions to “ JUSTIN KRENK ” Practice Location

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