Provider Demographics
NPI:1730393901
Name:KRUZEL, MARIE ALAINE (DC)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ALAINE
Last Name:KRUZEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 FLAT STONE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7876
Mailing Address - Country:US
Mailing Address - Phone:770-851-6703
Mailing Address - Fax:770-813-9006
Practice Address - Street 1:3460 SUMMIT RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1622
Practice Address - Country:US
Practice Address - Phone:770-813-0087
Practice Address - Fax:770-813-9005
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO05445111N00000X, 111NN0400X, 111NR0200X, 111NS0005X, 111NT0100X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiology
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Not Answered111NT0100XChiropractic ProvidersChiropractorThermography
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic