Provider Demographics
NPI:1417112137
Name:KRULL, JOY DENISE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DENISE
Last Name:KRULL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4615
Mailing Address - Country:US
Mailing Address - Phone:319-377-0722
Mailing Address - Fax:
Practice Address - Street 1:100 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1016
Practice Address - Country:US
Practice Address - Phone:319-356-1411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA011552251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01155OtherPHYSICAL THERAPY LICENSE