Provider Demographics
NPI:1790887750
Name:HAIG, JULIE MARIE (C PED)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MARIE
Last Name:HAIG
Suffix:
Gender:F
Credentials:C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036-2025
Mailing Address - Country:US
Mailing Address - Phone:317-872-3074
Mailing Address - Fax:765-557-7223
Practice Address - Street 1:1601 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036-2025
Practice Address - Country:US
Practice Address - Phone:317-872-3074
Practice Address - Fax:765-557-7223
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier