Provider Demographics
NPI:1598539595
Name:WRIGLEY, JULIE (ARDMS / RVT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WRIGLEY
Suffix:
Gender:F
Credentials:ARDMS / RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7865
Mailing Address - Country:US
Mailing Address - Phone:219-707-9617
Mailing Address - Fax:
Practice Address - Street 1:800 W BURRELL DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8898
Practice Address - Country:US
Practice Address - Phone:219-310-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2471S1302X
IN1066022085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography