Provider Information for 1023740339
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JULIE TAMISIEA
Sex: Female
NPI: 1023740339
Last Updated: 2022-06-27
Certification Date: 2022-06-27
Certification Date: 2022-06-27
Details
| Name | Value | ||||||||||||
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| NPI | 1023740339 | ||||||||||||
| Enumeration Date | 2022-06-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 313 BRETONSHIRE RD WILMINGTON, NC 28405-4005 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 313 BRETONSHIRE RD WILMINGTON, NC 28405-4005 United States Phone: 910-431-6567 | Fax: | ||||||||||||
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