Provider Demographics
NPI:1356559413
Name:BLASER, JULIA BEESON (MSPT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:BEESON
Last Name:BLASER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 TULIP ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3157
Mailing Address - Country:US
Mailing Address - Phone:303-485-4163
Mailing Address - Fax:303-485-4164
Practice Address - Street 1:1380 TULIP ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3157
Practice Address - Country:US
Practice Address - Phone:303-485-4163
Practice Address - Fax:303-485-4164
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist