Provider Demographics
NPI:1558447078
Name:LOMBARDO, JULIE M (PT MA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PT MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 POCAHONTAS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716
Mailing Address - Country:US
Mailing Address - Phone:608-222-0923
Mailing Address - Fax:
Practice Address - Street 1:411 PRAIRIE HEIGHTS DR
Practice Address - Street 2:STE 101 CAPITOL PHYSICAL THERAPY
Practice Address - City:VERONE
Practice Address - State:WI
Practice Address - Zip Code:53593
Practice Address - Country:US
Practice Address - Phone:608-848-6628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5916-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist