Provider Demographics
NPI:1043538291
Name:KREUZER, RANDALL W (DPT)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:W
Last Name:KREUZER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 BLACK OAK CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-6607
Mailing Address - Country:US
Mailing Address - Phone:315-212-3868
Mailing Address - Fax:561-395-2960
Practice Address - Street 1:1800 W WOOLBRIGHT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6398
Practice Address - Country:US
Practice Address - Phone:561-733-7677
Practice Address - Fax:561-733-7074
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist