Individual
DR. KEVAN D. KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
641 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 654-5413
(813) 643-1457
Mailing address
641 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 654-5413
(813) 643-1457
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CH 6698
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3815919-00
—
FL
Enumeration date
07/04/2006
Last updated
08/31/2012
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