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General NPI Number Information
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NPI Number | 1588852123
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Entity Type | Individual
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Provider Name | DANIEL KARDULAS
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Gender | Male
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 112 SANFORD RD
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City | WELLS
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State | ME
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Zip | 04090-5533
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Country | US
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Telephone | 207-646-0373
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Fax | 207-646-0381
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Provider Business Mailing Address
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Address Line | 138 MOSES GERRISH FARMER RD
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City | ELIOT
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State | ME
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Zip | 03903-1840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PA3094
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License Number State | ME
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