Provider Demographics
NPI:1043702376
Name:HILL, CARLEE KRUEGER (DPT)
Entity Type:Individual
Prefix:MS
First Name:CARLEE
Middle Name:KRUEGER
Last Name:HILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-1940
Mailing Address - Fax:314-747-7044
Practice Address - Street 1:1 PROGRESS POINT PKWY
Practice Address - Street 2:STE 100
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2211
Practice Address - Country:US
Practice Address - Phone:314-286-1940
Practice Address - Fax:314-747-7044
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO480057728Medicaid