Provider Demographics
NPI:1114107463
Name:MARTEL, JULIE MARIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:MARTEL
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 1:878 S. ROCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-601-9207
Mailing Address - Fax:248-650-8670
Practice Address - Street 1:21550 HARRINGTON
Practice Address - Street 2:STE D
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036
Practice Address - Country:US
Practice Address - Phone:586-783-7590
Practice Address - Fax:586-783-7876
Is Sole Proprietor?:No
Enumeration Date:2007-11-04
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist