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NPI Code Detail

MEDICARE: MR. MILES PATRICK KRUEGER

MEDICARE: MR. MILES PATRICK KRUEGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist8378MN

General Provider Information

NPI Number : 1023462157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MILES PATRICK KRUEGER
Provider Business Mailing Address
First Line : 804 WRIGHT ST
Second Line :
City : BRAINERD
State : MN
Zip : 56401-4441
Country : US
Telephone Number : 218-828-2501
Fax Number :
Provider Business Practice Location Address
First Line : 804 WRIGHT ST
Second Line :
City : BRAINERD
State : MN
Zip : 56401-4441
Country : US
Telephone Number : 218-828-2501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 04/14/2016

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Directions to “ MR. MILES PATRICK KRUEGER ” Practice Location

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