Provider Demographics
NPI:1316346455
Name:KILBURN, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KILBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-0629
Mailing Address - Country:US
Mailing Address - Phone:864-679-1600
Mailing Address - Fax:864-679-1605
Practice Address - Street 1:33 VALLEY VIEW TER
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-4548
Practice Address - Country:US
Practice Address - Phone:828-246-6566
Practice Address - Fax:828-246-6567
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62038025225100000X
NCP19674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1316346455Medicare PIN