MEDICARE: MR. ROBERT RICHARD KULBARSH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6915	OH

General Provider Information

NPI Number	:	1023009925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT RICHARD KULBARSH PT

Provider Business Mailing Address
First Line	:	4367 ROCKY RIVER DRIVE
Second Line	:	SUITE 100
City	:	CLEVELAND
State	:	OH
Zip	:	44135
Country	:	US
Telephone Number	:	216-252-8522
Fax Number	:	216-252-8722

Provider Business Practice Location Address
First Line	:	4367 ROCKY RIVER DRIVE
Second Line	:	SUITE 100
City	:	CLEVELAND
State	:	OH
Zip	:	44135
Country	:	US
Telephone Number	:	216-252-8522
Fax Number	:	216-252-8722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/08/2007

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