Provider Demographics
NPI:1093030413
Name:BURNS, JULIE KRISTIN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KRISTIN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 HEALTH BLVD., SUITE C
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1498
Mailing Address - Country:US
Mailing Address - Phone:386-258-9800
Mailing Address - Fax:386-238-0092
Practice Address - Street 1:569 HEALTH BLVD., SUITE C
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1498
Practice Address - Country:US
Practice Address - Phone:386-258-9800
Practice Address - Fax:386-238-0092
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 17972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist