Provider Demographics
NPI:1942722905
Name:O'BRIEN, JULIE LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 LEXINGTON AVE N STE 800
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8073
Mailing Address - Country:US
Mailing Address - Phone:651-483-1211
Mailing Address - Fax:
Practice Address - Street 1:3434 LEXINGTON AVE N STE 800
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8073
Practice Address - Country:US
Practice Address - Phone:651-483-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist