Provider Demographics
NPI:1871739706
Name:MATHISON, JULIET CATHRYN JANE (LMT, MHT)
Entity type:Individual
Prefix:MS
First Name:JULIET
Middle Name:CATHRYN JANE
Last Name:MATHISON
Suffix:
Gender:F
Credentials:LMT, MHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2044
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-2044
Mailing Address - Country:US
Mailing Address - Phone:770-465-6294
Mailing Address - Fax:
Practice Address - Street 1:1360 US 1
Practice Address - Street 2:SUITE 5
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5703
Practice Address - Country:US
Practice Address - Phone:770-465-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0025111225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist