Provider Demographics
NPI:1265479661
Name:BELILES, JULIE RENEE (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RENEE
Last Name:BELILES
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 1:4214 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-9252
Mailing Address - Country:US
Mailing Address - Phone:812-725-3035
Mailing Address - Fax:
Practice Address - Street 1:1011 W 78TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-3319
Practice Address - Country:US
Practice Address - Phone:317-414-8392
Practice Address - Fax:317-466-1154
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007089A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist