Provider Demographics
NPI:1063888774
Name:HARRIS, JULIE (PT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BELMONT AVE APT A6
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5917
Mailing Address - Country:US
Mailing Address - Phone:215-847-3075
Mailing Address - Fax:
Practice Address - Street 1:555 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3416
Practice Address - Country:US
Practice Address - Phone:215-293-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039030-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist