Provider Demographics
NPI:1538598586
Name:LABARGE, JULIE MARIE (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:LABARGE
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4225
Mailing Address - Country:US
Mailing Address - Phone:818-531-6671
Mailing Address - Fax:
Practice Address - Street 1:4454 VAN NUYS BLVD STE 216
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5777
Practice Address - Country:US
Practice Address - Phone:818-600-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32644111N00000X
CA15579171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist