Provider Demographics
NPI:1700855335
Name:VONDERHAAR, JON M (RKT)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:M
Last Name:VONDERHAAR
Suffix:
Gender:M
Credentials:RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 TRUXTUN AVE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0678
Mailing Address - Country:US
Mailing Address - Phone:661-587-2436
Mailing Address - Fax:
Practice Address - Street 1:4100 TRUXTUN AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0678
Practice Address - Country:US
Practice Address - Phone:661-587-2436
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist