Basic Information
| Provider Information | |||||||||
| NPI: | 1750458972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRUHM | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | DEANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ATC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WARD | ||||||||
| OtherFirstName: | JANET | ||||||||
| OtherMiddleName: | DEANNE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2004 SPROUL RD 1ST FLOOR | ||||||||
| Address2: | PREMIER SURGICAL ORTHOPEDIC ASSOCIATES | ||||||||
| City: | BROOMALL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103530800 | ||||||||
| FaxNumber: | 6103591686 | ||||||||
| Practice Location | |||||||||
| Address1: | 2004 SPROUL RD | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | BROOMALL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103530800 | ||||||||
| FaxNumber: | 6103591686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 02/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | RT003027 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.