Provider Demographics
NPI:1992713226
Name:FOOTE, JULIE C (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:C
Last Name:FOOTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-1410
Mailing Address - Country:US
Mailing Address - Phone:651-450-2366
Mailing Address - Fax:
Practice Address - Street 1:1345 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1410
Practice Address - Country:US
Practice Address - Phone:651-450-2366
Practice Address - Fax:651-450-2388
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN819680000Medicaid
MN171K3FOOtherMN BCBS
MN350051301OtherRAILROAD MEDICARE
MN819680000Medicaid
MN350051301OtherRAILROAD MEDICARE