Provider Demographics
NPI:1669716742
Name:DOTSON, JULIE ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:DOTSON
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:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67154-0101
Mailing Address - Country:US
Mailing Address - Phone:719-371-7938
Mailing Address - Fax:
Practice Address - Street 1:914 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4001
Practice Address - Country:US
Practice Address - Phone:719-371-7938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10219225100000X
KS11-04478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist