Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 5329 | OR |
N | 2251E1200X | Ergonomics | 5329 | OR |
N | 225XE1200X | Ergonomics | 5329 | OR |
N | 225XH1200X | Occupational Therapist - Hand | 5329 | OR |
NPI | 1134160690 |
---|---|
Provider Name | Mr. Robert Bruce Krueger |
First Address | Neskowin, OR 97149-0834 |
Second Address | Neskowin, OR 97149-9737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
231984 | (05) | OR |