Individual
CLARK ULLERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
308 SE 9TH ST, PELLA, IA 50219-2296
(866) 588-0230
Mailing address
416 5TH AVE W, OSKALOOSA, IA 52577-2654
(641) 660-3652
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03110
IA
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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