Provider Demographics
NPI:1669027983
Name:KRAMER, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:KRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:CARTER LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51510-1230
Mailing Address - Country:US
Mailing Address - Phone:402-740-9865
Mailing Address - Fax:
Practice Address - Street 1:902 AVENUE O
Practice Address - Street 2:
Practice Address - City:CARTER LAKE
Practice Address - State:IA
Practice Address - Zip Code:51510-1230
Practice Address - Country:US
Practice Address - Phone:402-740-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-04
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer