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General NPI Number Information
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NPI Number | 1851043061
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Entity Type | Individual
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Provider Name | JULIE MARIE DEYOUNG DPT, OCS
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 729 N MEDICAL CENTER DR W STE 121
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City | CLOVIS
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State | CA
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Zip | 93611-6880
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Country | US
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Telephone | 559-324-4057
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Fax |
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Provider Business Mailing Address
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Address Line | 1848 N CARSON AVE
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City | CLOVIS
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State | CA
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Zip | 93619-7412
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Country | US
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Telephone | 559-230-9801
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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 | 29948
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License Number State | CA
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