Individual
MR. BERNARD WANJALA KULOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
10040 HILLVIEW DR, PENSACOLA, FL 32514-5499
(850) 474-0570
Mailing address
4530 BALMORAL DR, PENSACOLA, FL 32504-9103
(850) 206-8537
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OT 8258
FL
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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