Healthcare Provider Details

I. General information

NPI: 1750476313
Provider Name (Legal Business Name): THOMAS B TRAUT RKT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 SAN DIMAS STREET, SUITE B100
BAKERSFIELD CA
93301
US

IV. Provider business mailing address

3838 SAN DIMAS STREET, SUITE B100
BAKERSFIELD CA
93301
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-0552
  • Fax: 661-322-7609
Mailing address:
  • Phone: 661-326-0552
  • Fax: 661-322-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: