Provider Demographics
NPI:1538415047
Name:KULOVITZ, WESTON ROBERT
Entity type:Individual
Prefix:
First Name:WESTON
Middle Name:ROBERT
Last Name:KULOVITZ
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 1:551 EIGER WAY
Mailing Address - Street 2:812
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3886
Mailing Address - Country:US
Mailing Address - Phone:970-946-0251
Mailing Address - Fax:
Practice Address - Street 1:551 EIGER WAY
Practice Address - Street 2:812
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3886
Practice Address - Country:US
Practice Address - Phone:970-946-0251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner