Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 01039565A | IN |
Y | 213ES0000X | Sports Medicine | 01039565A | IN |
NPI | 1346294121 |
---|---|
Provider Name | Daniel E Kraft |
First Address | Lebanon, IN 46052-8622 |
Second Address | Lebanon, IN 46052-8622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100382710 | (05) | IN |
F42468 | (02) | IN |