Provider Demographics
NPI:1205127891
Name:WESLING, JULIE (LMT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WESLING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:HOLISTIC
Other - Middle Name:MASSAGE
Other - Last Name:THERAPIES LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1021 OAK ARBOR CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084
Mailing Address - Country:US
Mailing Address - Phone:904-377-6696
Mailing Address - Fax:
Practice Address - Street 1:3840 BELFORT RD., SUITE 305
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:33216
Practice Address - Country:US
Practice Address - Phone:904-377-6696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA56383225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist