Provider Demographics
NPI:1821095837
Name:HAUGER, BRUCE K (PT)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:K
Last Name:HAUGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 BERGQUIST RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-9667
Mailing Address - Country:US
Mailing Address - Phone:218-525-1126
Mailing Address - Fax:
Practice Address - Street 1:5800 BERGQUIST RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55804-9667
Practice Address - Country:US
Practice Address - Phone:218-525-1126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist