Provider Demographics
NPI:1174364004
Name:MARTIN, JULIE (DAOM)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N 400 E
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9525
Mailing Address - Country:US
Mailing Address - Phone:435-770-7199
Mailing Address - Fax:
Practice Address - Street 1:514 N 400 E
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9525
Practice Address - Country:US
Practice Address - Phone:435-770-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist