Provider Demographics
NPI:1801133012
Name:WEINANS, JULIE ALLISON (PT)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ALLISON
Last Name:WEINANS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ALLISON
Other - Last Name:HEUVELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:24510 141ST AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374
Mailing Address - Country:US
Mailing Address - Phone:763-428-8587
Mailing Address - Fax:
Practice Address - Street 1:24510 141ST AVE N
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-9320
Practice Address - Country:US
Practice Address - Phone:763-428-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist