Provider Demographics
NPI:1770773624
Name:ULLMAN, JOHN J
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:ULLMAN
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 1:5011 WARWICK HILLS CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3185
Mailing Address - Country:US
Mailing Address - Phone:703-508-5976
Mailing Address - Fax:571-261-2746
Practice Address - Street 1:5011 WARWICK HILLS CT
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-3185
Practice Address - Country:US
Practice Address - Phone:703-508-5976
Practice Address - Fax:571-261-2746
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705105044171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications