Provider Demographics
NPI:1982444931
Name:KRUEGER OPTOMETRY LLC
Entity type:Organization
Organization Name:KRUEGER OPTOMETRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-280-0971
Mailing Address - Street 1:2800 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1123
Mailing Address - Country:US
Mailing Address - Phone:303-449-3419
Mailing Address - Fax:303-449-3411
Practice Address - Street 1:1001 E 120TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-5711
Practice Address - Country:US
Practice Address - Phone:303-280-0971
Practice Address - Fax:303-280-6757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KRUEGER OPTOMETRY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty