Provider Demographics
NPI:1386076933
Name:KULA, LAURA L (OTDR/L, MS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:KULA
Suffix:
Gender:F
Credentials:OTDR/L, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2591 COMPASS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8043
Mailing Address - Country:US
Mailing Address - Phone:847-729-6220
Mailing Address - Fax:847-729-1116
Practice Address - Street 1:2591 COMPASS RD STE 100
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8043
Practice Address - Country:US
Practice Address - Phone:847-729-6220
Practice Address - Fax:847-729-1116
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056003035174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist