Provider Demographics
NPI:1922439249
Name:EVANS, JULIE ANNE (MSPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:RUBINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:845 FIRST COLONIAL RD
Mailing Address - Street 2:APT. 119
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6160
Mailing Address - Country:US
Mailing Address - Phone:757-321-9292
Mailing Address - Fax:
Practice Address - Street 1:845 FIRST COLONIAL RD
Practice Address - Street 2:APT. 119
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6160
Practice Address - Country:US
Practice Address - Phone:757-321-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist