Provider Demographics
NPI:1467173559
Name:KRUSE, TIFFANY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:KRUSE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1014
Mailing Address - Country:US
Mailing Address - Phone:989-466-3275
Mailing Address - Fax:
Practice Address - Street 1:4851 E PICKARD ST STE 2600
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2042
Practice Address - Country:US
Practice Address - Phone:989-775-1662
Practice Address - Fax:989-775-1604
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics