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Individual

MRS. JEANETTE M KROGSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1046 PILINUT CT, SUNNYVALE, CA 94087-1841
(408) 718-7788
Mailing address
1046 PILINUT CT, SUNNYVALE, CA 94087-1841
(408) 718-7788

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT18777
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT18777
STATE LICENSE NUMBER
CA
Enumeration date
01/07/2008
Last updated
08/31/2015
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