Provider Demographics
NPI:1235759648
Name:BARR, JULIE KIM (LMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KIM
Last Name:BARR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 WILLOW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-3569
Mailing Address - Country:US
Mailing Address - Phone:865-801-5551
Mailing Address - Fax:
Practice Address - Street 1:1056 WILLOW CREEK CIR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-3569
Practice Address - Country:US
Practice Address - Phone:865-801-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-26
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11832225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty