Basic Information
Provider Information
NPI: 1629451455
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRAUER
FirstName: JULIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 REINEKERS LN
Address2: GR04
City: ALEXANDRIA
State: VA
PostalCode: 223142856
CountryCode: US
TelephoneNumber: 7032993111
FaxNumber: 7032991556
Practice Location
Address1: 225 REINEKERS LN
Address2: GR04
City: ALEXANDRIA
State: VA
PostalCode: 223142856
CountryCode: US
TelephoneNumber: 7032993111
FaxNumber: 7032991556
Other Information
ProviderEnumerationDate: 06/29/2015
LastUpdateDate: 06/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800X2305209590VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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