Healthcare Provider Details

I. General information

NPI: 1609763887
Provider Name (Legal Business Name): GRETA KUGLER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 9TH ST
DE PERE WI
54115-1393
US

IV. Provider business mailing address

17748 HICKORY TRL
LAKEVILLE MN
55044-6606
US

V. Phone/Fax

Practice location:
  • Phone: 920-336-5680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13939
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: