Healthcare Provider Details

I. General information

NPI: 1023009925
Provider Name (Legal Business Name): ROBERT RICHARD KULBARSH PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4367 ROCKY RIVER DRIVE SUITE 100
CLEVELAND OH
44135
US

IV. Provider business mailing address

4367 ROCKY RIVER DRIVE SUITE 100
CLEVELAND OH
44135
US

V. Phone/Fax

Practice location:
  • Phone: 216-252-8522
  • Fax: 216-252-8722
Mailing address:
  • Phone: 216-252-8522
  • Fax: 216-252-8722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6915
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: