Healthcare Provider Details

I. General information

NPI: 1063783611
Provider Name (Legal Business Name): JULIE ANN PINSON DPT, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 PALM BEACH ROAD GENESIS REHAB
STUART FL
34994
US

IV. Provider business mailing address

1825 SW ANGELICO LN
PORT SAINT LUCIE FL
34984-4456
US

V. Phone/Fax

Practice location:
  • Phone: 513-490-9943
  • Fax: 513-490-9943
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT25717
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: