MEDICARE: MR. JON M VONDERHAAR R.K.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	226300000X	Kinesiotherapist

General Provider Information

NPI Number	:	1700855335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JON M VONDERHAAR R.K.T.

Provider Business Mailing Address
First Line	:	4100 TRUXTUN AVE
Second Line	:	SUITE #200
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-0678
Country	:	US
Telephone Number	:	661-587-2436
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 TRUXTUN AVE
Second Line	:	SUITE #200
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-0678
Country	:	US
Telephone Number	:	661-587-2436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	07/08/2007

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