Provider Demographics
NPI:1477971760
Name:ALLISON, JULIE (LAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CARRIAGE LN STE 204
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6048
Mailing Address - Country:US
Mailing Address - Phone:843-708-9262
Mailing Address - Fax:
Practice Address - Street 1:4 CARRIAGE LN STE 204
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6048
Practice Address - Country:US
Practice Address - Phone:843-708-9262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL225171100000X
SC225171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist