Provider Demographics
NPI:1740482470
Name:ULRICH, DALE M (OTR)
Entity type:Individual
Prefix:MR
First Name:DALE
Middle Name:M
Last Name:ULRICH
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 LATIGO LOOP
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1589
Mailing Address - Country:US
Mailing Address - Phone:970-928-3226
Mailing Address - Fax:970-928-3238
Practice Address - Street 1:1200 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1564
Practice Address - Country:US
Practice Address - Phone:970-963-1500
Practice Address - Fax:970-963-9507
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist