Provider Demographics
NPI:1982955464
Name:ADELSON, JULIA LEA (PT)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:LEA
Last Name:ADELSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:LEA
Other - Last Name:ADELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:2448 E 26TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-4302
Mailing Address - Country:US
Mailing Address - Phone:918-743-9182
Mailing Address - Fax:918-744-1596
Practice Address - Street 1:4612 S HARVARD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2908
Practice Address - Country:US
Practice Address - Phone:918-744-1331
Practice Address - Fax:918-744-1596
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1999OtherSTATE LICENSE NUMBER 1999