Provider Demographics
NPI:1467847145
Name:KULLAS, NATASHA LAUREN (DC)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:LAUREN
Last Name:KULLAS
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 1:2441 US HIGHWAY 98 W
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5385
Mailing Address - Country:US
Mailing Address - Phone:850-622-0062
Mailing Address - Fax:
Practice Address - Street 1:2441 US HIGHWAY 98 W
Practice Address - Street 2:SUITE 103
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5385
Practice Address - Country:US
Practice Address - Phone:850-622-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor