Provider Demographics
NPI:1235242637
Name:STREY, JULIE A (LAT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:STREY
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 LANDRUM PL
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6319
Mailing Address - Country:US
Mailing Address - Phone:931-553-5495
Mailing Address - Fax:931-553-5497
Practice Address - Street 1:311 LANDRUM PL
Practice Address - Street 2:SUITE 600
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6319
Practice Address - Country:US
Practice Address - Phone:931-553-5495
Practice Address - Fax:931-553-5497
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI565-0392255A2300X
TNAT00000012532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer