Basic Information
| Provider Information | |||||||||
| NPI: | 1104129972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AXELROD | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | B. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 319 W COUNTY LINE RD | ||||||||
| Address2: | |||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190401605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152939901 | ||||||||
| FaxNumber: | 2152939902 | ||||||||
| Practice Location | |||||||||
| Address1: | 319 W COUNTY LINE RD | ||||||||
| Address2: | |||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190401605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152939901 | ||||||||
| FaxNumber: | 2152939902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2010 | ||||||||
| LastUpdateDate: | 12/16/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT010987L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.