MEDICARE: TIFFANY KRUSE PT, 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
1	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1467173559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY KRUSE PT, DPT

Provider Business Mailing Address
First Line	:	328 E WARWICK DR
Second Line	:
City	:	ALMA
State	:	MI
Zip	:	48801-1014
Country	:	US
Telephone Number	:	989-466-3275
Fax Number	:

Provider Business Practice Location Address
First Line	:	4851 E PICKARD ST STE 2600
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-2042
Country	:	US
Telephone Number	:	989-775-1662
Fax Number	:	989-775-1604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2022
Last Update Date	:	09/07/2022

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Directions to “ TIFFANY KRUSE PT, DPT” Practice Location

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