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General NPI Number Information
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NPI Number | 1285680702
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Entity Type | Individual
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Provider Name | JOSEPH S KRUGH PT
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8011 112TH STREET CT E
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City | PUYALLUP
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State | WA
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Zip | 98373-7814
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Country | US
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Telephone | 253-848-0662
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Fax | 253-848-8567
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Provider Business Mailing Address
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Address Line | 9315 GRAVELLY LAKE DR SW SUITE 203
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City | LAKEWOOD
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State | WA
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Zip | 98499-1574
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Country | US
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Telephone | 253-581-5200
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Fax | 253-581-5203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00009072
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License Number State | WA
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