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General NPI Number Information
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NPI Number | 1962407403
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Entity Type | Individual
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Provider Name | BRIAN J. KULBIEDA D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1300 W RIDGE ST STE 1
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City | MARQUETTE
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State | MI
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Zip | 49855-3194
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Country | US
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Telephone | 906-226-3663
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Fax | 906-226-2956
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Provider Business Mailing Address
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Address Line | 1300 W RIDGE ST STE 1
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City | MARQUETTE
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State | MI
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Zip | 49855-3194
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Country | US
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Telephone | 906-226-3663
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Fax | 906-226-2956
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | BK008347
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License Number State | MI
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