Provider Demographics
NPI:1265588370
Name:KRUGER, ROBIN LEE (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:KRUGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KINARD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2967
Mailing Address - Country:US
Mailing Address - Phone:803-405-7280
Mailing Address - Fax:803-405-7515
Practice Address - Street 1:2605 KINARD STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108
Practice Address - Country:US
Practice Address - Phone:803-405-7280
Practice Address - Fax:803-405-7515
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC00962OtherLICENSE #