Provider Demographics
NPI:1881878049
Name:KUZYK, VOLODAR ROMAN (LAC)
Entity type:Individual
Prefix:MR
First Name:VOLODAR
Middle Name:ROMAN
Last Name:KUZYK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 W ST RTE 89A STE 114
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5445
Mailing Address - Country:US
Mailing Address - Phone:928-239-9706
Mailing Address - Fax:
Practice Address - Street 1:2155 W ST RTE 89A STE 114
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5445
Practice Address - Country:US
Practice Address - Phone:928-239-9706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13194521-1201171100000X
CAAC-6518171100000X
CAAC 6518171100000X
MTMED-ACU-LIC-90462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist