Individual
MANDY KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 DODGE ST STE 105, DUBUQUE, IA 52003-5208
(563) 583-2007
Mailing address
2733 NEW HAVEN ST, DUBUQUE, IA 52001-5650
(515) 518-7328
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
088757
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088575
HIS
IA
Enumeration date
03/26/2020
Last updated
07/19/2023
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