Provider Demographics
NPI:1891139424
Name:WESLOSKY, JULIE SUNDERLAND (DPT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SUNDERLAND
Last Name:WESLOSKY
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:SUNDERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:2350 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-4088
Practice Address - Country:US
Practice Address - Phone:570-360-5915
Practice Address - Fax:570-560-6501
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist