Provider Demographics
NPI:1447380548
Name:POWELL, JULIE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELIZABETH
Last Name:POWELL
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 1:1311 10TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:DOROTHY
Mailing Address - State:NJ
Mailing Address - Zip Code:08317
Mailing Address - Country:US
Mailing Address - Phone:609-476-4453
Mailing Address - Fax:609-601-1161
Practice Address - Street 1:1311 10TH AVENUE
Practice Address - Street 2:
Practice Address - City:DOROTHY
Practice Address - State:NJ
Practice Address - Zip Code:08317
Practice Address - Country:US
Practice Address - Phone:609-476-4453
Practice Address - Fax:609-601-1161
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00560400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044004Medicare ID - Type Unspecified