Provider Demographics
NPI:1326592163
Name:POPIVCHAK, JULIANNE MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:MARIE
Last Name:POPIVCHAK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-373-7116
Practice Address - Street 1:26084 NORTHWEST FWY STE 140
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1003
Practice Address - Country:US
Practice Address - Phone:832-349-1168
Practice Address - Fax:832-602-2652
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012508225100000X
AL8562225100000X
OR62183225100000X
TN11185225100000X
TX1357726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist