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General NPI Number Information
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NPI Number | 1649243346
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Entity Type | Individual
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Provider Name | JULIE A GREEN DPT, CBIS
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Gender | Female
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Dates
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Enumeration Date | 02/12/2006
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 7711 SHELBY ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-5986
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Country | US
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Telephone | 317-378-7565
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Fax |
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Provider Business Mailing Address
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Address Line | 7441 HIGHPOINT CIR
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City | INDIANAPOLIS
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State | IN
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Zip | 46259-7667
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Country | US
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Telephone | 317-518-6265
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36000788A
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License Number State | IN
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