Healthcare Provider Details

I. General information

NPI: 1285116962
Provider Name (Legal Business Name): JULIE REOPELLE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 U.S. 287 FRONTAGE RD
MANSFIELD TX
76063
US

IV. Provider business mailing address

1580 U.S. 287 FRONTAGE RD
MANSFIELD TX
76063
US

V. Phone/Fax

Practice location:
  • Phone: 224-489-2662
  • Fax:
Mailing address:
  • Phone: 682-205-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1308941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: