MEDICARE: JOAN M KULOW 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	PT-0509	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831622596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN M KULOW PT

Provider Business Mailing Address
First Line	:	1210 CANYON HILLS RD
Second Line	:
City	:	THERMOPOLIS
State	:	WY
Zip	:	82443-3137
Country	:	US
Telephone Number	:	307-864-5591
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 GREAT PLAINS ROAD
Second Line	:
City	:	ARAPAHO
State	:	WY
Zip	:	82510-0014
Country	:	US
Telephone Number	:	307-856-9281
Fax Number	:	307-463-4489

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

Provider Enumeration Date	:	04/09/2017
Last Update Date	:	07/17/2020

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Directions to “ JOAN M KULOW PT” Practice Location

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