Provider Demographics
NPI:1023540754
Name:PROFIT, JULIA M (PT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:PROFIT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12422 ASKEW ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-1514
Mailing Address - Country:US
Mailing Address - Phone:816-331-9111
Mailing Address - Fax:816-348-0492
Practice Address - Street 1:924 N SCOTT AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:816-331-9111
Practice Address - Fax:816-348-0492
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017002582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist