Provider Demographics
NPI:1396891693
Name:FRITZ, JULIE MAE (PT, ATC, PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MAE
Last Name:FRITZ
Suffix:
Gender:F
Credentials:PT, ATC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 KENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3626
Mailing Address - Country:US
Mailing Address - Phone:801-484-1260
Mailing Address - Fax:
Practice Address - Street 1:2536 KENWOOD ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3626
Practice Address - Country:US
Practice Address - Phone:801-484-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5421460-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist