Provider Demographics
NPI:1205234598
Name:KRUEGER, ANDREW BURTON (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BURTON
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7656 DESIGN RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8675
Mailing Address - Country:US
Mailing Address - Phone:218-454-9355
Mailing Address - Fax:218-454-9356
Practice Address - Street 1:7656 DESIGN RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8675
Practice Address - Country:US
Practice Address - Phone:218-454-9355
Practice Address - Fax:218-454-9356
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor