MEDICARE: JULIA HELSTROM OSTEOPATHIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center	OS014415	PA

General Provider Information

NPI Number	:	1346657996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIA HELSTROM OSTEOPATHIC, LLC

Provider Business Mailing Address
First Line	:	3502 SCOTTS LN
Second Line	:	BUILDING 1, SUITE 112, MAILBOX B4
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1561
Country	:	US
Telephone Number	:	267-437-3299
Fax Number	:	267-437-2422

Provider Business Practice Location Address
First Line	:	3502 SCOTTS LN
Second Line	:	BUILDING 1, SUITE 112, MAILBOX B4
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1561
Country	:	US
Telephone Number	:	267-437-3299
Fax Number	:	267-437-2422

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. JULIA MAE HELSTROM
Credential	:	D.O.
Telephone Number	:	610-715-3320

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/15/2014

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