Provider Demographics
NPI:1265895080
Name:KULAGY PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:KULAGY PHYSICAL THERAPY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-209-9433
Mailing Address - Street 1:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90294-1295
Mailing Address - Country:US
Mailing Address - Phone:888-859-0145
Mailing Address - Fax:888-858-1601
Practice Address - Street 1:6080 CENTER DR.
Practice Address - Street 2:6TH FLOOR SUITE # 639
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-9205
Practice Address - Country:US
Practice Address - Phone:888-859-0145
Practice Address - Fax:888-858-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty