1639387707 NPI number — MS. BETTY W. ULMANIS LMT, CMMMT, NCTMB

Table of content: MS. BETTY W. ULMANIS LMT, CMMMT, NCTMB (NPI 1639387707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639387707 NPI number — MS. BETTY W. ULMANIS LMT, CMMMT, NCTMB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ULMANIS
Provider First Name:
BETTY
Provider Middle Name:
W.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMT, CMMMT, NCTMB
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KATZ
Provider Other First Name:
BETTY
Provider Other Middle Name:
WOOD
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639387707
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7196 EVANS RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAU CLAIRE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-251-0327
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9067 US HIGHWAY 31
Provider Second Line Business Practice Location Address:
SUITE #209
Provider Business Practice Location Address City Name:
BERRIEN SPRINGS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49103-1664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-251-0327
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA00015324 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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