Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC 14671 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 1896 | CO |
NPI | 1366523649 |
---|---|
Provider Name | Dr. Garry G Kraft |
First Address | Oxnard, CA 93033-3651 |
Second Address | Oxnard, CA 93033-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 23/03/2009 |