Provider Demographics
NPI:1881863769
Name:KRUEGER, KURT LOUIS (OTR, CHT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:LOUIS
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22731 NEWMAN ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2034
Mailing Address - Country:US
Mailing Address - Phone:313-791-0616
Mailing Address - Fax:313-791-0632
Practice Address - Street 1:22731 NEWMAN ST
Practice Address - Street 2:SUITE 100B
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2034
Practice Address - Country:US
Practice Address - Phone:313-791-0616
Practice Address - Fax:313-791-0632
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001121225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand