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Individual

MR. BYRON L KROEKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
200 CHINA GRADE LOOP, BAKERSFIELD, CA 93308-1735
(661) 615-6150
(661) 615-6151
Mailing address
1201 23RD ST, BAKERSFIELD, CA 93301-2306
(661) 327-4357
(661) 327-2311

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
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