Provider Demographics
NPI:1639387707
Name:ULMANIS, BETTY W (LMT, CMMMT, NCTMB)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:W
Last Name:ULMANIS
Suffix:
Gender:F
Credentials:LMT, CMMMT, NCTMB
Other - Prefix:MS
Other - First Name:BETTY
Other - Middle Name:WOOD
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7196 EVANS RD.
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49111
Mailing Address - Country:US
Mailing Address - Phone:269-251-0327
Mailing Address - Fax:
Practice Address - Street 1:9067 US HIGHWAY 31
Practice Address - Street 2:SUITE #209
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1664
Practice Address - Country:US
Practice Address - Phone:269-251-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015324225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist