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Individual

BRADLEY DAVIS KRUGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1172 W HAYDEN AVE, HAYDEN, ID 83835-8700
(208) 762-3332
(208) 762-4268
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6167
ID

Other

Enumeration date
06/14/2019
Last updated
06/14/2019
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