Provider Demographics
NPI:1467097543
Name:BLAIS, JULIA CHRISTINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CHRISTINE
Last Name:BLAIS
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 1:11 MAYHER ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2429
Mailing Address - Country:US
Mailing Address - Phone:413-241-4420
Mailing Address - Fax:
Practice Address - Street 1:516 CAREW ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2330
Practice Address - Country:US
Practice Address - Phone:413-787-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1320501225100000X
MA26579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist