Provider Demographics
NPI:1215329297
Name:PARANTALA, JULIE MARIE (DPT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:PARANTALA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:12032 BUSINESS BLVD
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577
Mailing Address - Country:US
Mailing Address - Phone:907-694-5515
Mailing Address - Fax:
Practice Address - Street 1:12032 BUSINESS BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7725
Practice Address - Country:US
Practice Address - Phone:907-694-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13214225100000X
HI4330225100000X
AK2887225100000X
ID3652225100000X
NV3115225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist