Provider Demographics
NPI:1306913991
Name:PEARSON, JULIE K (DC, BS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:K
Last Name:PEARSON
Suffix:
Gender:F
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SE OCEAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-600-8338
Mailing Address - Fax:772-382-2996
Practice Address - Street 1:800 SE OCEAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2448
Practice Address - Country:US
Practice Address - Phone:772-600-8338
Practice Address - Fax:772-382-2996
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH7585OtherSTATE NUMBER
FL4402447OtherUHC
FL629089OtherACN
FL3816001-00Medicaid
FL4402447OtherUHC
FLCH7585OtherSTATE NUMBER