Provider Demographics
NPI:1629363775
Name:BITELY, JULIANNE MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:MARIE
Last Name:BITELY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 LILAC CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-1822
Mailing Address - Country:US
Mailing Address - Phone:870-718-3538
Mailing Address - Fax:
Practice Address - Street 1:11 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3843
Practice Address - Country:US
Practice Address - Phone:870-718-3538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR100236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist