Provider Demographics
NPI:1275143927
Name:KRUEGER, ANDREW JOHN (DO, ATC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:KRUEGER
Suffix:
Gender:
Credentials:DO, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25001 EMERY RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5626
Mailing Address - Country:US
Mailing Address - Phone:216-286-1736
Mailing Address - Fax:
Practice Address - Street 1:25001 EMERY RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5626
Practice Address - Country:US
Practice Address - Phone:216-286-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016503208100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation