Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC005213L | PA |
NPI | 1366443426 |
---|---|
Provider Name | Dr. Todd Allen Ulery |
First Address | Scottdale, PA 15683-2458 |
Second Address | Scottdale, PA 15683-2458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013931630001 | (05) | PA |
U39530 | (02) | PA |