Provider Demographics
NPI:1306127451
Name:ULMER, BARBARA ANASTASIA (DPT)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANASTASIA
Last Name:ULMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CEDAR ST STE 153
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-1695
Mailing Address - Country:US
Mailing Address - Phone:320-219-9680
Mailing Address - Fax:320-759-1080
Practice Address - Street 1:700 CEDAR ST STE 153
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1695
Practice Address - Country:US
Practice Address - Phone:320-219-9680
Practice Address - Fax:320-759-1080
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03701225100000X
MN11424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11424OtherMN LICENCE