Provider Demographics
NPI:1528214251
Name:SHIRLEY, JULIA ANN (PT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:SHIRLEY
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 1:3506 TALL PINE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-2921
Mailing Address - Country:US
Mailing Address - Phone:336-707-2327
Mailing Address - Fax:
Practice Address - Street 1:1007 PORTERS NECK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-7383
Practice Address - Country:US
Practice Address - Phone:910-686-6506
Practice Address - Fax:910-686-6385
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist