Provider Demographics
NPI:1528394707
Name:EIBENSTEINER, JULIE ANN (DPT)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:EIBENSTEINER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11304 DAVENPORT CIRCLE NE #A
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55449
Mailing Address - Country:US
Mailing Address - Phone:651-592-1625
Mailing Address - Fax:
Practice Address - Street 1:11304 DAVENPORT CIRCLE NE #A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55449
Practice Address - Country:US
Practice Address - Phone:651-592-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist