Provider Demographics
NPI:1700839768
Name:ULMER, PIOTR
Entity Type:Individual
Prefix:
First Name:PIOTR
Middle Name:
Last Name:ULMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MARKET PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2347
Mailing Address - Country:US
Mailing Address - Phone:865-588-8000
Mailing Address - Fax:865-588-9800
Practice Address - Street 1:151 MARKET PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2347
Practice Address - Country:US
Practice Address - Phone:865-588-8000
Practice Address - Fax:865-588-9800
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT3366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4007801OtherBCBS
4007801OtherBCBS
TN3654393Medicare PIN