| Doctor Name: | MR. MILES PATRICK KRUEGER |
| NPI Number: | 1023462157 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 8378 |
| Business Practice Address: | 804 Wright St Brainerd, MN - 564014441 |
| Business Phone Number: | 2188282501 |
| Business Fax Number: | |
| Mailing Address: | 804 Wright St, BRAINERD |
| State: | MN |
| Postal Code: | 564014441 |
| Phone Number: | 2188282501 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2016 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 8378 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |