Provider Demographics
NPI:1952640435
Name:MCMAHAN, JULIE A (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:MCMAHAN
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 1:11160 BROKEN BIT LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7551
Mailing Address - Country:US
Mailing Address - Phone:804-752-6350
Mailing Address - Fax:
Practice Address - Street 1:11160 BROKEN BIT LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7551
Practice Address - Country:US
Practice Address - Phone:804-752-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist