Provider Demographics
NPI:1922289735
Name:NEWBERG, JULIE ANN (PHYSICAL THERAPY AST)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:NEWBERG
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Gender:F
Credentials:PHYSICAL THERAPY AST
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Mailing Address - Street 1:225 SMITH AVE N
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2533
Mailing Address - Country:US
Mailing Address - Phone:651-288-5180
Mailing Address - Fax:651-288-5188
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:SUITE 301
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2533
Practice Address - Country:US
Practice Address - Phone:651-288-5180
Practice Address - Fax:651-288-5188
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
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Provider Licenses
StateLicense IDTaxonomies
VA2306601966225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant