MEDICARE: AUSTIN ULRICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTL.0013279	CO
2	225100000X	Physical Therapist	LPT-31604	AZ

General Provider Information

NPI Number	:	1114306941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN ULRICH

Provider Business Mailing Address
First Line	:	1777 W SAINT MARYS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2687
Country	:	US
Telephone Number	:	520-884-9819
Fax Number	:	520-884-0175

Provider Business Practice Location Address
First Line	:	7355 S HOUGHTON RD STE 109
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85747-9380
Country	:	US
Telephone Number	:	520-664-9100
Fax Number	:	520-664-1099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	03/04/2021

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Directions to “ AUSTIN ULRICH ” Practice Location

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