Provider Demographics
NPI:1134192511
Name:KULP, DONNA M (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:KULP
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 1:52 MORGANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611
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
Practice Address - Country:US
Practice Address - Phone:610-208-0404
Practice Address - Fax:610-208-0717
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005216L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKU485509OtherHIGHMARK BLUE SHIELD
U39504Medicare UPIN
485509Medicare ID - Type Unspecified