Healthcare Provider Details

I. General information

NPI: 1003006909
Provider Name (Legal Business Name): JULIA ANN PINKHAM L.M.T., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIA GONZALEZ

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 RIVERSIDE DR
COLUMBUS OH
43221
US

IV. Provider business mailing address

2170 RIVERSIDE DR
COLUMBUS OH
43221-4076
US

V. Phone/Fax

Practice location:
  • Phone: 614-486-7525
  • Fax: 614-488-4736
Mailing address:
  • Phone: 614-486-7525
  • Fax: 614-488-4736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13564
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number118
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: