Provider Demographics
NPI:1003981838
Name:GULCZYNSKI, DON E (LOTR)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:E
Last Name:GULCZYNSKI
Suffix:
Gender:M
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38185 WILLOW LAKE DR S
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4196
Mailing Address - Country:US
Mailing Address - Phone:225-677-9208
Mailing Address - Fax:
Practice Address - Street 1:8768 QUARTERS LAKE RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2195
Practice Address - Country:US
Practice Address - Phone:225-752-3330
Practice Address - Fax:225-752-0888
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA211895225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist