Healthcare Provider Details

I. General information

NPI: 1396926077
Provider Name (Legal Business Name): JULIE ANNE HURTUHISE OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4516 ZENITH AVE S
MINNEAPOLIS MN
55410
US

IV. Provider business mailing address

4516 ZENITH AVE S
MINNEAPOLIS MN
55410
US

V. Phone/Fax

Practice location:
  • Phone: 612-920-5398
  • Fax:
Mailing address:
  • Phone: 612-920-5398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number101787
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: