Provider Demographics
NPI:1487646196
Name:BEEMAN, JULIE M (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BEEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6922 HILLSDALE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2040
Mailing Address - Country:US
Mailing Address - Phone:317-621-7820
Mailing Address - Fax:317-621-7824
Practice Address - Street 1:6922 HILLSDALE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2040
Practice Address - Country:US
Practice Address - Phone:317-621-7820
Practice Address - Fax:317-621-7824
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012605225100000X
IN05008842A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK15644Medicare ID - Type UnspecifiedWOL INDIVIDUAL PROVIDER #