Provider Demographics
NPI:1881657864
Name:KULP CHIROPRACTIC CLINIC, INC
Entity Type:Organization
Organization Name:KULP CHIROPRACTIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KULP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-208-0404
Mailing Address - Street 1:52 MORGANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1650
Mailing Address - Country:US
Mailing Address - Phone:610-208-0404
Mailing Address - Fax:610-208-0717
Practice Address - Street 1:52 MORGANTOWN RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1650
Practice Address - Country:US
Practice Address - Phone:610-208-0404
Practice Address - Fax:610-208-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005216L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101634Medicare PIN