Provider Demographics
NPI:1275556938
Name:STROUP, JULIE A (RPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:STROUP
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 S CLIFF AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5437
Mailing Address - Country:US
Mailing Address - Phone:605-335-8326
Mailing Address - Fax:605-332-2708
Practice Address - Street 1:5132 S CLIFF AVE
Practice Address - Street 2:STE # 4
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5437
Practice Address - Country:US
Practice Address - Phone:605-335-8326
Practice Address - Fax:605-373-9971
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0218208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4995623OtherBCBS
SD5834292Medicaid
IA0580076Medicaid
SD5834292Medicaid