Basic Information
| Provider Information | |||||||||
| NPI: | 1093237349 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRIEGER | ||||||||
| FirstName: | NATHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2478 DONNA LN | ||||||||
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| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194642687 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849949660 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 ENTERPRISE DR | ||||||||
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| City: | LIMERICK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194681218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003219999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2017 | ||||||||
| LastUpdateDate: | 07/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | PT026074 | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.