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Organization
PREMIERCARE
Active
Organization
PREMIERCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY RICHARD KRUSE MD (OWNER)
(970) 927-8563
Entity
Organization
Contact information
Practice address
227 MIDLAND AVE STE 15B, BASALT, CO 81621-8119
(970) 927-8563
(970) 927-5245
Mailing address
227 MIDLAND AVE STE 15B, BASALT, CO 81621-8119
(970) 927-8563
(970) 927-5245
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/25/2007
Last updated
08/04/2008
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