Provider Demographics
NPI:1437639101
Name:STONEBROOK, JULIA WRAY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:WRAY
Last Name:STONEBROOK
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 1:1890 HIGHWAY 194
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38066-3840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9263 OSBORN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-5922
Practice Address - Country:US
Practice Address - Phone:901-496-1057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000011798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist