MEDICARE: MRS. JULIE A. THORNTON

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	174400000X	Specialist

General Provider Information

NPI Number	:	1659410231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE A. THORNTON

Provider Business Mailing Address
First Line	:	7216 W 80TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66204-3718
Country	:	US
Telephone Number	:	913-649-1851
Fax Number	:	913-649-4715

Provider Business Practice Location Address
First Line	:	7216 W 80TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66204-3718
Country	:	US
Telephone Number	:	913-649-1851
Fax Number	:	913-649-4715

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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