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General NPI Number Information
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NPI Number | 1619324175
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Entity Type | Individual
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Provider Name | JULIA C KOLDER
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Gender | Female
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Dates
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Enumeration Date | 05/15/2016
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 799 N HEWITT RD
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 630-888-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 799 N HEWITT RD
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City | YPSILANTI
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State | MI
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Zip | 48197-1701
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000023408
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License Number State |
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