Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | A3817 | MD |
NPI | 1306187919 |
---|---|
Provider Name | Michal Kulyk |
First Address | Baltimore, MD 21214-1228 |
Second Address | Baltimore, MD 21214-3204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 06/03/2013 |