Provider Demographics
NPI:1922508035
Name:COULSON, JULIE M (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:COULSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 TSCHUDY HILL RD SW
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43837-9200
Mailing Address - Country:US
Mailing Address - Phone:330-204-8624
Mailing Address - Fax:
Practice Address - Street 1:8330 TSCHUDY HILL RD SW
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43837-9200
Practice Address - Country:US
Practice Address - Phone:330-204-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist