Provider Demographics
NPI:1437498730
Name:BOTIMER, JULIE KATHRYN (LAC, DIPL OM)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KATHRYN
Last Name:BOTIMER
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3304
Mailing Address - Country:US
Mailing Address - Phone:989-671-9755
Mailing Address - Fax:989-439-1946
Practice Address - Street 1:704 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3304
Practice Address - Country:US
Practice Address - Phone:989-671-9755
Practice Address - Fax:989-439-1946
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5401000029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist