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Individual

MRS. LISA MARIE ULMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3998 RED LION RD STE 130, PHILADELPHIA, PA 19114-1443
(215) 612-4151
(215) 612-5265
Mailing address
3998 RED LION RD STE 130, PHILADELPHIA, PA 19114-1443
(215) 612-4151
(215) 612-5265

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052818
PA

Other

Enumeration date
02/06/2007
Last updated
05/03/2012
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