Provider Demographics
NPI:1770781536
Name:SIMPSON, JULIE (DPT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DPT
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 323
Mailing Address - Street 2:
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-0323
Mailing Address - Country:US
Mailing Address - Phone:517-545-3200
Mailing Address - Fax:517-545-3236
Practice Address - Street 1:1225 W GRAND RIVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-3975
Practice Address - Country:US
Practice Address - Phone:517-545-3200
Practice Address - Fax:517-545-3236
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5423225100000X
MI5501015556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR243077Medicaid
ORP00617752OtherRRMC
OR084171026OtherBLUE CROSS
OR084171026OtherBLUE CROSS