Individual
MS. COREY DIETRICH ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MSPT
Contact information
Practice address
400 W ARBROOK BLVD, SUITE 151, ARLINGTON, TX 76014-3181
(817) 472-8383
(817) 472-8386
Mailing address
966 N GARDEN RIDGE BLVD, SUITE 530, LEWISVILLE, TX 75077-2876
(972) 420-6605
(972) 436-2770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1125342
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1125342
PHYSICAL THERAPIST - REGULAR LICENSE
TX
05
—
2844359-01
—
TX
01
—
81646T
BCBS ID
TX
Enumeration date
12/04/2006
Last updated
07/18/2014
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