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General NPI Number Information
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NPI Number | 1245730936
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Entity Type | Individual
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Provider Name | ANNE MARIE ULICKI DPT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 17101 ROTUNDA DR
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City | DEARBORN
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State | MI
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Zip | 48124-4084
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Country | US
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Telephone | 313-791-4333
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Fax | 313-791-4310
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Provider Business Mailing Address
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Address Line | 22252 OLMSTEAD ST
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City | DEARBORN
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State | MI
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Zip | 48124-4714
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Country | US
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Telephone | 734-612-3522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501013205
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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