Individual
DALE KUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T
Contact information
Practice address
5524 GALLATIN LN, N CHARLESTON, SC 29420-6803
(843) 906-7169
Mailing address
5524 GALLATIN LN, N CHARLESTON, SC 29420-6803
(843) 906-7169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4916
SC
Other
Enumeration date
02/16/2015
Last updated
02/10/2016
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