Provider Demographics
NPI:1801593645
Name:KULASINAC, LUKA
Entity type:Individual
Prefix:
First Name:LUKA
Middle Name:
Last Name:KULASINAC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 SUNNYS HALO DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1115
Mailing Address - Country:US
Mailing Address - Phone:770-605-6017
Mailing Address - Fax:
Practice Address - Street 1:1445 SUNNYS HALO DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1115
Practice Address - Country:US
Practice Address - Phone:770-605-6017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer