Provider Demographics
NPI:1487765384
Name:BOKERMANN, JULIE CHRISTINE (MSPT ATC CSCS)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:CHRISTINE
Last Name:BOKERMANN
Suffix:
Gender:F
Credentials:MSPT ATC CSCS
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Other - First Name:
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Mailing Address - Street 1:8228 BRENTWOOD INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2815
Mailing Address - Country:US
Mailing Address - Phone:314-722-3366
Mailing Address - Fax:314-781-3448
Practice Address - Street 1:8228 BRENTWOOD INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-2815
Practice Address - Country:US
Practice Address - Phone:314-722-3366
Practice Address - Fax:314-781-3448
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2002018242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000025419Medicare ID - Type Unspecified