Provider Demographics
NPI:1942351036
Name:LANG, JULIE A
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:LANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W STREETSBORO ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2755
Mailing Address - Country:US
Mailing Address - Phone:330-655-2804
Mailing Address - Fax:330-673-3371
Practice Address - Street 1:180 W STREETSBORO ST STE 1B
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2755
Practice Address - Country:US
Practice Address - Phone:330-655-2804
Practice Address - Fax:330-673-3371
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4813761744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341628909001OtherMEDICAL MUTUAL
OH341628909001OtherMEDICAL MUTUAL