Provider Demographics
NPI:1063670438
Name:KRUEGER, MARCIA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:ANN
Last Name:KRUEGER
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 1:7810 TERREY PINE CT
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1186
Mailing Address - Country:US
Mailing Address - Phone:952-937-1226
Mailing Address - Fax:952-906-1811
Practice Address - Street 1:7810 TERREY PINE CT
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1186
Practice Address - Country:US
Practice Address - Phone:952-937-1226
Practice Address - Fax:952-906-1811
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor