Provider Demographics
NPI:1164042859
Name:VULETICH, KAROL RAE
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:RAE
Last Name:VULETICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-8456
Mailing Address - Country:US
Mailing Address - Phone:307-272-3997
Mailing Address - Fax:
Practice Address - Street 1:2704 WEST AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-8456
Practice Address - Country:US
Practice Address - Phone:307-272-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator