Provider Demographics
NPI:1902299936
Name:KRULL CLINIC, PC
Entity Type:Organization
Organization Name:KRULL CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:KRULL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:308-221-6850
Mailing Address - Street 1:1929 WEST A ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4577
Mailing Address - Country:US
Mailing Address - Phone:308-221-6850
Mailing Address - Fax:308-221-6852
Practice Address - Street 1:1929 WEST A ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4577
Practice Address - Country:US
Practice Address - Phone:308-221-6850
Practice Address - Fax:308-221-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy