Provider Demographics
NPI:1568093508
Name:SCHOSSOW, JULIE RAE (ABOC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RAE
Last Name:SCHOSSOW
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-5844
Mailing Address - Country:US
Mailing Address - Phone:641-753-5042
Mailing Address - Fax:641-753-5042
Practice Address - Street 1:116 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-5844
Practice Address - Country:US
Practice Address - Phone:641-753-5042
Practice Address - Fax:641-753-5042
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician