Provider Demographics
NPI:1881979334
Name:BAUCHER, JULIE M (PT)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:BAUCHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1076 RIBAUT RD SUITE 102
Mailing Address - Street 2:CAROLINA SPORTSCARE AND PHYSICAL THERAPY
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5490
Mailing Address - Country:US
Mailing Address - Phone:843-521-1970
Mailing Address - Fax:843-521-0908
Practice Address - Street 1:1076 RIBAUT RD STE 102
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5490
Practice Address - Country:US
Practice Address - Phone:843-521-1970
Practice Address - Fax:843-521-0908
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2112225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant