Individual
DR. DALTON KRENCIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
4715 KIRBY LOOP RD, FORT PIERCE, FL 34981-5345
(772) 577-6964
(772) 461-9954
Mailing address
1702 MARINER BAY BLVD, FORT PIERCE, FL 34949-3613
(772) 577-6964
(772) 461-9954
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT22788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT22788
FLORIDA DEPARTMENT OF HEALTH STATE LICENSE NUMBER
FL
Enumeration date
02/21/2022
Last updated
02/21/2022
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