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NPI Code Detail

MEDICARE: GAYLA J KULWICKI OTA

MEDICARE:   GAYLA J KULWICKI  OTA
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
1224Z00000XOccupational Therapy Assistant1800657KS

General Provider Information

NPI Number : 1407026032
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLA J KULWICKI OTA
Provider Business Mailing Address
First Line : 1099 HIGHLAND CT
Second Line : APT. F
City : COFFEYVILLE
State : KS
Zip : 67337-2941
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2921 W 1ST ST
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-2441
Country : US
Telephone Number : 620-870-9686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2008
Last Update Date : 03/11/2008

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Directions to “ GAYLA J KULWICKI OTA” Practice Location

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