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General NPI Number Information
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NPI Number | 1548584253
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Entity Type | Individual
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Provider Name | JULIE PERSON HAILEY MS, PT, LAT, C
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Gender | Female
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 1 FOX RUN DR
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City | CLINTON
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State | MA
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Zip | 01510-1463
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Country | US
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Telephone | 978-365-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FOX RUN DR
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City | CLINTON
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State | MA
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Zip | 01510-1463
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Country | US
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Telephone | 978-365-2778
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 6938
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 411
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License Number State | MA
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