Provider Demographics
NPI:1235565466
Name:GREGORY, MAUREEN KRAUSS (LAT ATC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:KRAUSS
Last Name:GREGORY
Suffix:
Gender:F
Credentials:LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SQUIRE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-7111
Mailing Address - Country:US
Mailing Address - Phone:484-903-6357
Mailing Address - Fax:
Practice Address - Street 1:75 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3732
Practice Address - Country:US
Practice Address - Phone:484-903-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0056832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer