Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0187 | SD |
NPI | 1124279195 |
---|---|
Provider Name | Stephan Kulzer |
First Address | Sioux Falls, SD 57105-1016 |
Second Address | Sioux Falls, SD 57105-1016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 08/10/2008 |