Provider Demographics
NPI:1063508919
Name:KULIK, RONALD STEPHAN II (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STEPHAN
Last Name:KULIK
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11664 PREFERENCE WAY
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2486
Mailing Address - Country:US
Mailing Address - Phone:703-505-1677
Mailing Address - Fax:
Practice Address - Street 1:11495 SUNSET HILLS RD STE 240
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5257
Practice Address - Country:US
Practice Address - Phone:703-742-7856
Practice Address - Fax:703-740-4064
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA033589C41Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
VAU33011Medicare UPIN