Provider Demographics
NPI:1215129580
Name:KRUSE, KARLA JO LAABS (MAOTR/L)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:JO LAABS
Last Name:KRUSE
Suffix:
Gender:F
Credentials:MAOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 NORTH KNISS AVE
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:MN
Mailing Address - Zip Code:56156-2519
Mailing Address - Country:US
Mailing Address - Phone:507-449-1229
Mailing Address - Fax:
Practice Address - Street 1:1600 NORTH KNISS AVE
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:MN
Practice Address - Zip Code:56156-2519
Practice Address - Country:US
Practice Address - Phone:507-449-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01611225X00000X
MN102430225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist