Individual
JAMIE KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
550 SW INDUSTRIAL WAY, 130, BEND, OR 97702-1084
(541) 306-6541
Mailing address
44 NW PARK PL, BEND, OR 97703-2955
(541) 390-5264
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20451
OR
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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