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NPI Code Detail

MEDICARE: DR. HEATHER JO ALVINA KRUEGER DPT

MEDICARE:  DR. HEATHER JO ALVINA KRUEGER  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1457842130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER JO ALVINA KRUEGER DPT
Provider Business Mailing Address
First Line : 2410 QUEEN AVE
Second Line :
City : SHAKOPEE
State : MN
Zip : 55379-4526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4815 N 60TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-4150
Country : US
Telephone Number : 952-356-9899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2018
Last Update Date : 06/28/2021

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Directions to “ DR. HEATHER JO ALVINA KRUEGER DPT” Practice Location

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