Individual
JEREMY KULCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4172
Mailing address
34 CHESTER DR APT 202, SCOTT DEPOT, WV 25560-5608
(304) 687-3805
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
660
WV
Other
Enumeration date
12/12/2014
Last updated
06/10/2024
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