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General NPI Number Information
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NPI Number | 1568830073
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Entity Type | Individual
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Provider Name | KRISTA KUGLIN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 1894 37TH ST SE
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City | SAINT CLOUD
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State | MN
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Zip | 56304-9508
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Country | US
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Telephone | 320-227-2606
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Fax |
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Provider Business Mailing Address
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Address Line | 43316 248TH AVE
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City | FREEPORT
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State | MN
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Zip | 56331-9638
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Country | US
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Telephone |
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Fax |
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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 | 10958
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9373
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License Number State | MT
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