MEDICARE: JULIE MEREDETH DIPERT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT014596	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12077852	OTHER	OH	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548582372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MEREDETH DIPERT DPT

Provider Business Mailing Address
First Line	:	5000 ROCKSIDE RD
Second Line	:	STE 500
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2178
Country	:	US
Telephone Number	:	216-459-2846
Fax Number	:	216-901-2803

Provider Business Practice Location Address
First Line	:	435 W LIBERTY ST
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-2221
Country	:	US
Telephone Number	:	216-749-6650
Fax Number	:	330-723-8920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2010
Last Update Date	:	11/06/2019

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