Provider Demographics
NPI:1801989330
Name:MICHAEL, JULIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 S COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-2351
Mailing Address - Country:US
Mailing Address - Phone:270-465-6612
Mailing Address - Fax:270-465-6612
Practice Address - Street 1:404 S COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-2351
Practice Address - Country:US
Practice Address - Phone:270-465-6612
Practice Address - Fax:270-465-6612
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4267OtherCHA
KY000000068916OtherANTHEM BLUE CROSS
KY614971OtherACN
KY7878Medicare UPIN
KY0787801Medicare ID - Type Unspecified