Organization Name: | KRONCKE WOUND MANAGEMENT PLLC |
NPI Number: | 1043499007 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDERICK G KRONCKE (OWNER) |
Mailing Address: | 156 Candlewood Rd Rocky Mount |
State: | NC US |
Postal Code: | 278042107 |
Phone Number: | 2529033124 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2007 |
NPI Last Update Date: | 12/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 16896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |