Provider Demographics
NPI:1639222300
Name:SNOWDEN, JULIE WAITS (PT, MHS, OCS)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:WAITS
Last Name:SNOWDEN
Suffix:
Gender:F
Credentials:PT, MHS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 WILLIAMSBURG PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5093
Mailing Address - Country:US
Mailing Address - Phone:502-412-4486
Mailing Address - Fax:502-412-4490
Practice Address - Street 1:9400 WILLIAMSBURG PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5093
Practice Address - Country:US
Practice Address - Phone:502-412-4486
Practice Address - Fax:502-412-4490
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00060823OtherRAILROAD MEDICARE
KY5024603Medicare PIN