Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shad Dj Kuklewski, LPTA

Individual provider Physical Therapy Assistant · NPI 1639756000

Shad Dj Kuklewski, LPTA is a Physical Therapy Assistant in Grosse Pointe Farms, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
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Practice location Address checks out

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610
Phone: (313) 640-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502000445 (MI)

Record details

NPI number1639756000
Entity typeIndividual (Type 1)
GenderMale
Credentials LPTA
Sole proprietorNo
NPI enumeratedMarch 24, 2021
Last updated in NPPESMarch 24, 2021
Certification dateMarch 24, 2021

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