Basic Information
| Provider Information | |||||||||
| NPI: | 1295926814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIMMICK | ||||||||
| FirstName: | JULIA | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 LUMBER ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOPKINTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017482363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085441540 | ||||||||
| FaxNumber: | 5085441541 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 LUMBER ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOPKINTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017482363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085441540 | ||||||||
| FaxNumber: | 5085441541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 03/16/2017 | ||||||||
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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 | PT02101 | RI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 17475 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.