Individual
MR. BRIAN MICHAEL KEDRA
Active
Individual
MR. BRIAN MICHAEL KEDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10002272
DE
225100000X
Physical Therapist
Primary
PT018889
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11796745
CAQH
—
01
—
1366647703
TRICARE CHAMPUS
—
05
—
1366647703
—
DE
01
—
2066834
PA BS
—
01
—
2872734000
AMERIHEALTH IBC
—
01
—
5070-0085
CARE FIRST
—
01
—
92830401
NCA
—
Enumeration date
06/17/2007
Last updated
12/27/2024
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