Provider Demographics
NPI:1902283245
Name:CUPP, JULIA (PT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CUPP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15301 W 87TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1401
Mailing Address - Country:US
Mailing Address - Phone:913-492-4888
Mailing Address - Fax:
Practice Address - Street 1:15301 W 87TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1401
Practice Address - Country:US
Practice Address - Phone:913-492-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist