Provider Demographics
NPI:1912969056
Name:ATRIA KRUGER, MARISA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:ANN
Last Name:ATRIA KRUGER
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:165 S UNION BLVD
Mailing Address - Street 2:460
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2215
Mailing Address - Country:US
Mailing Address - Phone:303-865-4290
Mailing Address - Fax:303-865-4294
Practice Address - Street 1:165 S UNION BLVD
Practice Address - Street 2:#460
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2215
Practice Address - Country:US
Practice Address - Phone:303-865-4290
Practice Address - Fax:303-865-4294
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2007-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO99142899152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU30306Medicare UPIN