Provider Demographics
NPI:1649281742
Name:OSBORNE, JULIA CORAL (PT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CORAL
Last Name:OSBORNE
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 1:5300 DTC PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3023
Mailing Address - Country:US
Mailing Address - Phone:720-306-8261
Mailing Address - Fax:720-306-8231
Practice Address - Street 1:5300 DTC PKWY
Practice Address - Street 2:STE 400
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3023
Practice Address - Country:US
Practice Address - Phone:720-306-8261
Practice Address - Fax:720-306-8231
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0007688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA06-6600Medicare Oscar/Certification