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1770011413
CORISSA RAE KRUSE
PARK RIVER, ND
NPI
1770011413
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: ND 2011)
Enumeration Date
2017-05-25
Last Update Date
2017-05-25
Business Address
CORISSA RAE KRUSE
115 VIVIAN ST W
PARK RIVER, ND 58270-4540
Phone number: 701-284-4570
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Mailing Address
CORISSA RAE KRUSE
12823 OAK GROVE DR
THIEF RIVER FALLS, MN 56701-8414
Phone number: 218-686-0188
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