Provider Demographics
NPI:1235262577
Name:CLINE, JULIA ANN (PROVIDER)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:CLINE
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34732 CLINE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74957-9650
Mailing Address - Country:US
Mailing Address - Phone:580-244-3595
Mailing Address - Fax:
Practice Address - Street 1:34732 CLINE RD
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:OK
Practice Address - Zip Code:74957-9650
Practice Address - Country:US
Practice Address - Phone:580-244-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37V628191296171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor