Healthcare Provider Details

I. General information

NPI: 1710438494
Provider Name (Legal Business Name): JULIE BALLINGER P.T., D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE ANDREWS P.T., D.P.T.

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 AIRLINE RD STE 106
ARLINGTON TN
38002-4894
US

IV. Provider business mailing address

6600 STAGE RD STE 129
BARTLETT TN
38134-3838
US

V. Phone/Fax

Practice location:
  • Phone: 901-867-8989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10800
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: