Healthcare Provider Details

I. General information

NPI: 1720295397
Provider Name (Legal Business Name): JULIA L ARNDT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MAPLELEAF DR
COLLINSVILLE IL
62234-5224
US

IV. Provider business mailing address

2021 MAPLELEAF DR
COLLINSVILLE IL
62234-5224
US

V. Phone/Fax

Practice location:
  • Phone: 618-704-8232
  • Fax:
Mailing address:
  • Phone: 618-704-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.018081
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: