Provider Demographics
NPI:1033282694
Name:HASSELL, JULIE A (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:HASSELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:85 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1648
Mailing Address - Country:US
Mailing Address - Phone:651-404-1002
Mailing Address - Fax:
Practice Address - Street 1:85 PLEASANT DR
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1648
Practice Address - Country:US
Practice Address - Phone:651-404-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist