Provider Demographics
NPI:1023179256
Name:GYOERKOE, JULIE A (OTR)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:GYOERKOE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 LYTTON LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6835
Mailing Address - Country:US
Mailing Address - Phone:704-438-5966
Mailing Address - Fax:980-346-5376
Practice Address - Street 1:1104 LYTTON LN
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-6835
Practice Address - Country:US
Practice Address - Phone:704-438-5966
Practice Address - Fax:980-346-5376
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13439225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist