Doctor Name: | DUSTIN KRUSE |
NPI Number: | 1548433469 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | |
Business Practice Address: | 7615 W 38th Ave Suite B133 Wheat Ridge, CO - 800336172 |
Business Phone Number: | 3034232520 |
Business Fax Number: | 3034232536 |
Mailing Address: | 7615 W 38th Ave, Suite B133 WHEAT RIDGE |
State: | CO |
Postal Code: | 800336172 |
Phone Number: | 3034232520 |
Fax Number: | 3034232536 |
NPI Enumeration Date: | 04/11/2008 |
NPI Last Update Date: | 10/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |