Provider Demographics
NPI:1275574006
Name:LOMONACO, JULIE NOELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:NOELLE
Last Name:LOMONACO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 TERNES RD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1031
Mailing Address - Country:US
Mailing Address - Phone:734-673-8172
Mailing Address - Fax:
Practice Address - Street 1:405 E CHICAGO BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1513
Practice Address - Country:US
Practice Address - Phone:517-423-2639
Practice Address - Fax:517-426-0639
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11282202OtherCAQH ID