Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RICHARD WARREN KRUCKEBERG, P.T., O.C.S., C.H.T.
Active Sole ProprietorMR. RICHARD WARREN KRUCKEBERG, P.T., O.C.S., C.H.T. is a Physical Therapy Assistant healthcare provider located in MATTOON, Illinois. NPI 1245362920 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · MATTOON, IL
Registration Details
- NPI Number
- 1245362920
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 9, 2007 (19.415645944457 yrs)
- Last Updated
- Sep 19, 2011
- License
-
070.002766 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
100 PROFESSIONAL PLZMATTOON, IL, 619389252Browse IL providers · Browse ZIP 61938
- Phone
- 2173451245
- Fax
- 2173451253
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in MATTOON, IL
| Name | Credential | NPI |
|---|---|---|
| MARK MASSE | PT, MHS | 1801912167 |
| MS. SARA N MASSE | MPT | 1568588838 |
| LISA K CLAPP | — | 1376663039 |
| SARAH HOPKINS | — | 1811016611 |
| ANDREA YURS | — | 1457470288 |
| STACY CARROLL | — | 1225157027 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.