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NPI 1760973754

NPI 1760973754 : JACOB DULSKI DPT : GOLDEN, CO

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General NPI Number Information
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    NPI Number           |    1760973754
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    Entity Type          |    Individual 
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    Provider Name        |    JACOB DULSKI DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/24/2018
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    Last Update Date     |    07/25/2025
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Provider Practice Location Address
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    Address Line         |    112 N RUBEY DR 
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    City                 |    GOLDEN
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    State                |    CO
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    Zip                  |    80403-3210
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    Country              |    US
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    Telephone            |    716-467-7938
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    112 N RUBEY DR 
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    City                 |    GOLDEN
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    State                |    CO
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    Zip                  |    80403-3210
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2305211930
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    License Number State |    VA
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PTL.16507
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    License Number State |    CO
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