Provider Demographics
NPI:1922214543
Name:CULI, VARLAN JOSELITO (OTR)
Entity Type:Individual
Prefix:MR
First Name:VARLAN
Middle Name:JOSELITO
Last Name:CULI
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CHISHOLM PL
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-6573
Mailing Address - Country:US
Mailing Address - Phone:260-580-1795
Mailing Address - Fax:
Practice Address - Street 1:3811 PARNELL AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-1409
Practice Address - Country:US
Practice Address - Phone:260-482-4651
Practice Address - Fax:260-483-9505
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003954A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist