Provider Demographics
NPI:1437277688
Name:WOLF, JULIE KAYE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KAYE
Last Name:WOLF
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20245 N 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-2279
Mailing Address - Country:US
Mailing Address - Phone:623-580-9136
Mailing Address - Fax:
Practice Address - Street 1:455 N 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-3924
Practice Address - Country:US
Practice Address - Phone:623-687-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist