Provider Demographics
NPI:1558311803
Name:DEJULIA, JOSEPH JOHN (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JOHN
Last Name:DEJULIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1107
Mailing Address - Country:US
Mailing Address - Phone:724-962-9657
Mailing Address - Fax:
Practice Address - Street 1:124 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SHARPSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16150-1107
Practice Address - Country:US
Practice Address - Phone:724-962-9657
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009149E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist