Healthcare Provider Details

I. General information

NPI: 1841245784
Provider Name (Legal Business Name): JULIE ANN WELNA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9233 N GREEN BAY AVE
MILWAUKEE WI
53209-1103
US

IV. Provider business mailing address

9120 W STANFORD CT
MEQUON WI
53097-3730
US

V. Phone/Fax

Practice location:
  • Phone: 414-270-8153
  • Fax:
Mailing address:
  • Phone: 262-512-9323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number02682-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: