Provider Demographics
NPI:1780845875
Name:KAMMERUD, JULIE LYNN (DPT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:KAMMERUD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:KUMMERFELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 W 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-1252
Mailing Address - Country:US
Mailing Address - Phone:715-609-1310
Mailing Address - Fax:715-609-1315
Practice Address - Street 1:711 W 9TH ST N
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-1252
Practice Address - Country:US
Practice Address - Phone:715-609-1310
Practice Address - Fax:715-609-1315
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11030-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist