Doctor Name: | JILL KRUSE |
NPI Number: | 1326415001 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA |
License Number: | MT.0016017 |
Business Practice Address: | 5775 N Union Blvd Colorado Springs, CO - 809181744 |
Business Phone Number: | 7194347044 |
Business Fax Number: | 7193751276 |
Mailing Address: | 5775 N Union Blvd, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809181744 |
Phone Number: | 7194347044 |
Fax Number: | 7193751276 |
NPI Enumeration Date: | 08/28/2015 |
NPI Last Update Date: | 08/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT.0016017 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |