Individual
MS. KATHLEEN KRUEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1246 S 11TH AVE, WAUSAU, WI 54401-5922
(715) 842-8476
Mailing address
1246 S 11TH AVE, WAUSAU, WI 54401-5922
(715) 842-8476
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
103554
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41486400
—
WI
Enumeration date
10/01/2007
Last updated
10/01/2007
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