Provider Demographics
NPI:1194126318
Name:CROSS, JULIA D (PT, DPT, ATC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:D
Last Name:CROSS
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 LONGWATER CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 LONGWATER CIR STE 201
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1643
Practice Address - Country:US
Practice Address - Phone:781-347-4686
Practice Address - Fax:781-347-4696
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-07
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28002255A2300X, 2255A2300X
MA23753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist