Healthcare Provider Details

I. General information

NPI: 1881732675
Provider Name (Legal Business Name): THOMAS ONEAL ULMER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 SOUTH COUNTY RD
FREEMAN SD
57029
US

IV. Provider business mailing address

PO BOX 357
FREEMAN SD
57029
US

V. Phone/Fax

Practice location:
  • Phone: 605-925-4229
  • Fax:
Mailing address:
  • Phone: 605-925-4229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number646
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: