Individual
MR. BYRON L KROEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT198871
MEDICARE INDIVIDUAL PTAN
CA
01
—
P00077627
RAILROAD MEDICARE PTAN
CA
01
—
ZZZ21295Z
MEDICARE GROUP PTAN
CA
Enumeration date
08/16/2005
Last updated
02/15/2010
Update your record
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