Clark, Julie Dallia

Clark, Julie Dallia is an individual health care provider with primary practice located at 1132 Rutherford Rd , Greenville SC 29609-3927. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Clark, Julie Dallia can be contacted via phone (864) 250-0005.

Contact Information

Primary practice address
1132 Rutherford Rd Greenville SC 29609-3927
Phone: (864) 250-0005
Fax: (864) 250-0028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 714 South Carolina

Profile Details

NPI number 1457336059
LBN Legal business name Clark, Julie Dallia
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457336059 NPPES
South Carolina MEDICAID TH0980

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