Provider Demographics
NPI:1124039342
Name:ULAT, ALMIRA M (PT)
Entity Type:Individual
Prefix:
First Name:ALMIRA
Middle Name:M
Last Name:ULAT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-0391
Mailing Address - Country:US
Mailing Address - Phone:270-781-0028
Mailing Address - Fax:270-781-0007
Practice Address - Street 1:1600 SCOTTSVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3217
Practice Address - Country:US
Practice Address - Phone:270-781-0028
Practice Address - Fax:270-781-0007
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-004877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87001970Medicaid
KY0993509Medicare PIN