Individual
DIANA LYNN KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
208 PHILLIPS BLVD, SAUK CITY, WI 53583-1523
(608) 644-0109
(608) 644-0112
Mailing address
208 PHILLIPS BLVD, SAUK CITY, WI 53583-1523
(608) 644-0109
(608) 644-0112
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
21754
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30384700
—
WI
Enumeration date
08/20/2006
Last updated
07/08/2007
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