Provider Demographics
NPI:1811355613
Name:MCGREGOR, JULIE LYNN (MED)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LYNN
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:HENNINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:3301 WOODSIDE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3951
Mailing Address - Country:US
Mailing Address - Phone:248-635-0123
Mailing Address - Fax:
Practice Address - Street 1:3301 WOODSIDE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3951
Practice Address - Country:US
Practice Address - Phone:248-635-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other