Provider Demographics
NPI:1710698659
Name:WERLA, JULIE ANN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:WERLA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12100 W DEARBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3840
Mailing Address - Country:US
Mailing Address - Phone:414-793-5073
Mailing Address - Fax:
Practice Address - Street 1:12100 W DEARBOURN AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3840
Practice Address - Country:US
Practice Address - Phone:414-793-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11946-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist