Provider Demographics
NPI:1962706028
Name:KRUGER, KRISTIN LYNN (DC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNN
Last Name:KRUGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 RYANS WAY
Mailing Address - Street 2:#201
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-4527
Mailing Address - Country:US
Mailing Address - Phone:763-258-3189
Mailing Address - Fax:763-201-5848
Practice Address - Street 1:639 RYANS WAY
Practice Address - Street 2:#201
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-4527
Practice Address - Country:US
Practice Address - Phone:763-600-8355
Practice Address - Fax:763-201-5848
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5468111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor