Provider Demographics
NPI:1225179112
Name:KRUEGER, ANDREW CARY (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CARY
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-1855
Mailing Address - Country:US
Mailing Address - Phone:715-623-4687
Mailing Address - Fax:715-623-0697
Practice Address - Street 1:436 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-1855
Practice Address - Country:US
Practice Address - Phone:715-623-4687
Practice Address - Fax:715-623-0697
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3428012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor