Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 171754 | KY |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-2724 | NV |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT.0004668 | CO |
NPI | 1083158844 |
---|---|
Provider Name | Tor Aleksander Ulla |
First Address | Las Vegas, NV 89123-2818 |
Second Address | Lexington, KY 40504-2930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2016 |
Last Update Date | 09/07/2021 |