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General NPI Number Information
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NPI Number | 1104937531
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Entity Type | Organization
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Legal Business Name | INGRID M. KRUSE DC, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 1021 MARTIN ST S
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City | PELL CITY
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State | AL
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Zip | 35128-2360
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Country | US
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Telephone | 205-338-4545
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Fax | 205-338-4553
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Provider Business Mailing Address
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Address Line | 1021 MARTIN ST S
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City | PELL CITY
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State | AL
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Zip | 35128-2360
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Country | US
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Telephone | 205-405-6099
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Fax | 205-338-4553
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Authorized Official
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Title or Position | OWNER
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Name | INGRID M KRUSE
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Credential | DC
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Telephone | 205-405-6099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2037
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License Number State | AL
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