Provider Demographics
NPI:1912499005
Name:SADDORIS, JULIE RIDGEWAY
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RIDGEWAY
Last Name:SADDORIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 GUNNER RUN RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20733-2108
Mailing Address - Country:US
Mailing Address - Phone:410-610-4962
Mailing Address - Fax:
Practice Address - Street 1:116 DEFENSE HWY STE 101
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7040
Practice Address - Country:US
Practice Address - Phone:410-897-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist