Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 5176 | OH |
NPI | 1003940685 |
---|---|
Provider Name | Mrs. Denise Ellen Kulas |
First Address | Parma Heights, OH 44130-3239 |
Second Address | Parma Heights, OH 44130-2984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |