Provider Demographics
NPI:1538347356
Name:FLANEGAN, JULIE SNIDER (LMT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:SNIDER
Last Name:FLANEGAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 NW 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4146
Mailing Address - Country:US
Mailing Address - Phone:352-336-6644
Mailing Address - Fax:352-377-6945
Practice Address - Street 1:1240 NW 11TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4146
Practice Address - Country:US
Practice Address - Phone:352-336-6644
Practice Address - Fax:352-377-6945
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA22691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist