Provider Demographics
NPI:1154651404
Name:GAISER, JULIE E (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:E
Last Name:GAISER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 W COMMERCE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-6202
Mailing Address - Country:US
Mailing Address - Phone:501-847-0107
Mailing Address - Fax:
Practice Address - Street 1:608 W COMMERCE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-6202
Practice Address - Country:US
Practice Address - Phone:501-847-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-09
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist