Provider Demographics
NPI:1285080812
Name:TELLEFSEN, JULIE C (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:TELLEFSEN
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26830 RIDGEBROOK DR
Mailing Address - Street 2:STE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6464
Mailing Address - Country:US
Mailing Address - Phone:813-345-4915
Mailing Address - Fax:
Practice Address - Street 1:2008 ASHLEY OAKS CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6400
Practice Address - Country:US
Practice Address - Phone:813-907-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT313682251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic