Provider Demographics
NPI:1548584253
Name:HAILEY, JULIE PERSON (MS, PT, LAT, C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:PERSON
Last Name:HAILEY
Suffix:
Gender:F
Credentials:MS, PT, LAT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-1463
Mailing Address - Country:US
Mailing Address - Phone:978-365-2778
Mailing Address - Fax:
Practice Address - Street 1:1 FOX RUN DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-1463
Practice Address - Country:US
Practice Address - Phone:978-365-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA69382251X0800X
MA4112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer