| NPI | 1265629745 |
|---|---|
| Former Legal Business Name | KEVAN D. KRUSE, P.A. |
| Entity Type | Organization |
| Authorized Contact | LINETTE LEE HENRY Office Manager 813-654-5413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: FL CH6698) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2012-08-20 |