Provider Demographics
NPI:1215676655
Name:KROGMAN, BRANDON ROBERT (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ROBERT
Last Name:KROGMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2474 TIMBERWOOD LN NE
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2562
Mailing Address - Country:US
Mailing Address - Phone:507-676-6012
Mailing Address - Fax:
Practice Address - Street 1:35 STATE AVE
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-6368
Practice Address - Country:US
Practice Address - Phone:507-497-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic