Provider Demographics
NPI:1861862476
Name:MANCZUROWSKY, JULIA ROSE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ROSE
Last Name:MANCZUROWSKY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WHITNEY LN
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01568-1514
Mailing Address - Country:US
Mailing Address - Phone:508-320-8533
Mailing Address - Fax:
Practice Address - Street 1:11808 GRANT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3613
Practice Address - Country:US
Practice Address - Phone:877-230-3885
Practice Address - Fax:402-505-9753
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT43083225100000X
OR61500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist