Provider Demographics
NPI:1730312851
Name:JULIAN, JASON (MPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:JULIAN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 GROTON DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2404
Mailing Address - Country:US
Mailing Address - Phone:818-653-5424
Mailing Address - Fax:
Practice Address - Street 1:537 GROTON DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2404
Practice Address - Country:US
Practice Address - Phone:818-653-5424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic