Provider Demographics
NPI:1568652360
Name:KRALJIC, JOHN F (RPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:KRALJIC
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6408
Mailing Address - Country:US
Mailing Address - Phone:701-838-5722
Mailing Address - Fax:
Practice Address - Street 1:1821 7TH ST SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6408
Practice Address - Country:US
Practice Address - Phone:701-838-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND177174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist