Provider Demographics
NPI:1558351882
Name:CHEVAN, JULIA (PT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CHEVAN
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 1:8 COSMIAN AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1227
Mailing Address - Country:US
Mailing Address - Phone:413-584-8928
Mailing Address - Fax:
Practice Address - Street 1:263 ALDEN ST
Practice Address - Street 2:SPRINGFIELD COLLEGE
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3707
Practice Address - Country:US
Practice Address - Phone:413-748-3569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist