Provider Demographics
NPI:1689862930
Name:SAVIDGE, JULIA G (OTRL SPIT)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:G
Last Name:SAVIDGE
Suffix:
Gender:F
Credentials:OTRL SPIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20970
Mailing Address - Street 2:CHEYENNE REGIONAL MEDICAL CENTER
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7020
Mailing Address - Country:US
Mailing Address - Phone:307-773-8012
Mailing Address - Fax:307-633-7676
Practice Address - Street 1:2600 E 18TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5511
Practice Address - Country:US
Practice Address - Phone:307-633-7370
Practice Address - Fax:307-633-7202
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2482225X00000X
WYOTR-902225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1689862930Medicaid
WYW24252Medicare PIN