Provider Demographics
NPI:1962600817
Name:MUCHNICK, JULIANNE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:MUCHNICK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 COLONIAL TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1160
Mailing Address - Country:US
Mailing Address - Phone:770-942-1945
Mailing Address - Fax:770-942-1905
Practice Address - Street 1:3609 COLONIAL TRL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1160
Practice Address - Country:US
Practice Address - Phone:770-942-1945
Practice Address - Fax:770-942-1905
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT000482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist