Healthcare Provider Details

I. General information

NPI: 1861386674
Provider Name (Legal Business Name): JULIE ANN WITHROW CPRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 120
CINCINNATI OH
45236-2919
US

IV. Provider business mailing address

12165 STATE ST NE
ALLIANCE OH
44601-8323
US

V. Phone/Fax

Practice location:
  • Phone: 513-607-5128
  • Fax: 888-832-2040
Mailing address:
  • Phone: 330-237-3263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.006105
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: