Provider Demographics
NPI:1568524221
Name:ARTHUR, JULIA RENE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:RENE
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:JULIA
Other - Middle Name:RENE
Other - Last Name:BRISCOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:314 GOFF MTN RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313
Mailing Address - Country:US
Mailing Address - Phone:304-776-5031
Mailing Address - Fax:304-204-6332
Practice Address - Street 1:314 GOFF MTN RD
Practice Address - Street 2:SUITE 13
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313
Practice Address - Country:US
Practice Address - Phone:304-776-5031
Practice Address - Fax:304-204-6332
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV002248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV311504453OtherACORDIA
WV7302308-000Medicaid
WV1714906OtherBLUE CROSS BLUE SHIELD
WV31150445300OtherWORKERS COMP
WV7750401OtherAETNA
WVP00013944OtherRAILROAD MEDICARE
WV311504453OtherCIGNA
WVP00013944OtherRAILROAD MEDICARE
WV7750401OtherAETNA
WV7302308-000Medicaid