Provider Demographics
NPI:1629013529
Name:ULMER, ELISABETH MARIE (LAT, ATC, EMT-B)
Entity Type:Individual
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First Name:ELISABETH
Middle Name:MARIE
Last Name:ULMER
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Gender:F
Credentials:LAT, ATC, EMT-B
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Mailing Address - Street 1:2100 W FAIRY CHASM RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1510
Mailing Address - Country:US
Mailing Address - Phone:414-540-3304
Mailing Address - Fax:414-540-3600
Practice Address - Street 1:2100 W FAIRY CHASM RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-1510
Practice Address - Country:US
Practice Address - Phone:414-540-3304
Practice Address - Fax:414-540-3600
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2010-09-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer