Corissa Rae Kruse

NPI #1770011413 in Park River, North Dakota

Provider Information

NPI Number: 1770011413
Entity Type: Individual
Name: Corissa Rae Kruse
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: May 25, 2017
Last Updated: May 25, 2017

Practice Location

Address: 115 VIVIAN ST W
City: Park River
State: North Dakota
ZIP Code: 58270-4540
Phone: (701) 284-4570

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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