Healthcare Provider Details

I. General information

NPI: 1396679346
Provider Name (Legal Business Name): JULIA KOOSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-2200
  • Fax: 814-372-2535
Mailing address:
  • Phone: 814-375-2200
  • Fax: 814-372-2535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT237141
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: