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General NPI Number Information
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NPI Number | 1609312081
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Entity Type | Individual
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Provider Name | COLIN KRUSE
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Gender | Male
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 12/08/2024
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Provider Practice Location Address
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Address Line | 555 COLLEGE DR STE C
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City | HENDERSON
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State | NV
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Zip | 89015-1546
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Country | US
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Telephone | 725-254-1251
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Fax | 725-254-1252
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Provider Business Mailing Address
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Address Line | 555 COLLEGE DR STE C
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City | HENDERSON
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State | NV
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Zip | 89015-1546
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Country | US
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Telephone | 725-254-1251
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Fax | 725-254-1252
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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 | LPT-32298
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License Number State | AZ
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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 | PT60700019
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4132
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License Number State | NV
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