Provider Demographics
NPI:1740471549
Name:GRAHE, JULIE A (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:GRAHE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:G
Other - Last Name:KEEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:138 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85501-2602
Mailing Address - Country:US
Mailing Address - Phone:928-425-3207
Mailing Address - Fax:
Practice Address - Street 1:138 S BROAD ST
Practice Address - Street 2:
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501-2602
Practice Address - Country:US
Practice Address - Phone:928-425-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor