Healthcare Provider Details

I. General information

NPI: 1316831787
Provider Name (Legal Business Name): JULIA CAROLYN-ROSE WOPAT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BASECAMP WAY # 105
FRISCO CO
80443-5967
US

IV. Provider business mailing address

211 SWAN ST
GENOA WI
54632-2900
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-3169
  • Fax:
Mailing address:
  • Phone: 608-304-4267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0020629
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: