Provider Demographics
NPI:1356789663
Name:PIETRZAK, KAITLYN SLUKA (PT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:SLUKA
Last Name:PIETRZAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ANN
Other - Last Name:SLUKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4004
Mailing Address - Country:US
Mailing Address - Phone:984-974-7932
Mailing Address - Fax:
Practice Address - Street 1:100 SPRUNT ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7811
Practice Address - Country:US
Practice Address - Phone:984-974-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006234225100000X
TX1250327225100000X
UT8523324-2401225100000X
NCP20960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist