Provider Demographics
NPI:1114202355
Name:KRUSLING, JESSE THOMAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:THOMAS
Last Name:KRUSLING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1702
Mailing Address - Country:US
Mailing Address - Phone:740-779-2905
Mailing Address - Fax:740-779-2909
Practice Address - Street 1:850 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1702
Practice Address - Country:US
Practice Address - Phone:740-779-2905
Practice Address - Fax:740-779-2909
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129675183500000X
IN26023459A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist