Provider Demographics
NPI:1518621911
Name:PAULUS, JOLIE NICOLE (PT)
Entity Type:Individual
Prefix:
First Name:JOLIE
Middle Name:NICOLE
Last Name:PAULUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JOLIE
Other - Middle Name:NICOLE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:321 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1915
Mailing Address - Country:US
Mailing Address - Phone:908-627-3325
Mailing Address - Fax:
Practice Address - Street 1:707 HAMILTON ST FL 4
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-2407
Practice Address - Country:US
Practice Address - Phone:484-862-3001
Practice Address - Fax:484-862-3013
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist