Provider Demographics
NPI:1972875375
Name:POWERS, JULIE D
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3558
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-3558
Mailing Address - Country:US
Mailing Address - Phone:702-237-1631
Mailing Address - Fax:775-751-8738
Practice Address - Street 1:8219 FOX AVE
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89061-8840
Practice Address - Country:US
Practice Address - Phone:702-237-1631
Practice Address - Fax:775-751-8738
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner