Provider Demographics
NPI:1497775621
Name:ALEXANDER, JULIE ANN (ATC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17476 HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-9658
Mailing Address - Country:US
Mailing Address - Phone:320-597-2702
Mailing Address - Fax:
Practice Address - Street 1:720 4TH AVE. SO., HAH304
Practice Address - Street 2:
Practice Address - City:ST, CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4498
Practice Address - Country:US
Practice Address - Phone:320-308-3827
Practice Address - Fax:320-308-2099
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer