Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3699 | OR |
NPI | 1003936915 |
---|---|
Provider Name | Dr. Daniel Krueger |
First Address | Hillsboro, OR 97124-5412 |
Second Address | Hillsboro, OR 97124-5412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |