Provider Demographics
NPI:1699434829
Name:BROBACK, JULIE KAROLYN (DPT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KAROLYN
Last Name:BROBACK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KAROLYN
Other - Last Name:SOHRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:10250 E MOUNTAIN VIEW RD APT 106
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5303
Mailing Address - Country:US
Mailing Address - Phone:507-995-2535
Mailing Address - Fax:
Practice Address - Street 1:9917 N 95TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4586
Practice Address - Country:US
Practice Address - Phone:480-314-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-033538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist