Provider Demographics
NPI:1326079625
Name:KULJU, KRISTIN BETH (DC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:BETH
Last Name:KULJU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 RYE RD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-749-8552
Mailing Address - Fax:941-749-8553
Practice Address - Street 1:1850 RYE RD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212
Practice Address - Country:US
Practice Address - Phone:941-749-8552
Practice Address - Fax:941-749-8553
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6578Medicare ID - Type Unspecified
FLU87968Medicare UPIN
U87968Medicare UPIN