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NPI 1215033428

NPI 1215033428 : JULIE MARIE RICE PAC : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1215033428
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    Entity Type          |    Individual 
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    Provider Name        |    JULIE MARIE RICE PAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/15/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1009 A DUPONT SQUARE 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40207
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    Country              |    US
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    Telephone            |    502-894-9950
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    Fax                  |    502-894-9991
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Provider Business Mailing Address
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    Address Line         |    1100 PERSIMMON RIDGE DR 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40245-7031
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA564
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    License Number State |    KY
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