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NPI Code Detail

MEDICARE: HAYLEY ADDISON KRUEGER DPT

MEDICARE: HAYLEY ADDISON KRUEGER DPT
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
1225100000XPhysical Therapist11216SC

General Provider Information

NPI Number : 1235808072
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYLEY ADDISON KRUEGER DPT
Provider Business Mailing Address
First Line : 1013 SUMMER CAPE CIR
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-6397
Country : US
Telephone Number : 832-315-9814
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 17 N
Second Line :
City : NORTH MYRTLE BEACH
State : SC
Zip : 29582-2229
Country : US
Telephone Number : 843-353-3460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2021
Last Update Date : 09/06/2024

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Directions to “ HAYLEY ADDISON KRUEGER DPT” Practice Location

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