Individual
MR. CHARLES K KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS SLP
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1416 FOOTHILL DR, KAMAS, UT 84036-9616
(801) 455-2190
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1104144102
UT
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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