Provider Demographics
NPI:1942693288
Name:KRUEGER, MEGAN C
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:C
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 OLD TROY PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5740
Mailing Address - Country:US
Mailing Address - Phone:937-233-1230
Mailing Address - Fax:937-236-8930
Practice Address - Street 1:4710 OLD TROY PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-5740
Practice Address - Country:US
Practice Address - Phone:937-233-1230
Practice Address - Fax:937-236-8930
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist