Provider Demographics
NPI:1831566769
Name:MARTH, JULIANN E (DPT)
Entity type:Individual
Prefix:DR
First Name:JULIANN
Middle Name:E
Last Name:MARTH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:101 UNITED DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-7428
Mailing Address - Country:US
Mailing Address - Phone:618-343-1122
Mailing Address - Fax:618-343-1444
Practice Address - Street 1:101 UNITED DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-7428
Practice Address - Country:US
Practice Address - Phone:618-343-1122
Practice Address - Fax:618-343-1444
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070021544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist