Provider Demographics
NPI:1023269859
Name:KROUSE, KRISTI K (MSPT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:K
Last Name:KROUSE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25341 448TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:SD
Mailing Address - Zip Code:57048-5617
Mailing Address - Country:US
Mailing Address - Phone:605-363-5379
Mailing Address - Fax:
Practice Address - Street 1:25341 448TH AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:SD
Practice Address - Zip Code:57048-5617
Practice Address - Country:US
Practice Address - Phone:605-363-5379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5992251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics