Provider Demographics
NPI:1164847182
Name:URQUIOLA, JULIAN (CFTS)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:
Last Name:URQUIOLA
Suffix:
Gender:M
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 VISCOUNT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-6052
Mailing Address - Country:US
Mailing Address - Phone:901-365-1100
Mailing Address - Fax:901-365-2255
Practice Address - Street 1:3835 VISCOUNT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6052
Practice Address - Country:US
Practice Address - Phone:901-365-1100
Practice Address - Fax:901-365-2255
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCFTS1623174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist