Individual
KENYON W KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 752-5111
Mailing address
PO BOX 8210, KALISPELL, MT 59904-1210
(701) 220-2791
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
10069
ND
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-52109
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13544
—
ND
Enumeration date
08/31/2006
Last updated
11/07/2018
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