Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 103242 | MN |
NPI | 1043410079 |
---|---|
Provider Name | Dr. Julie Anne Champagne |
First Address | Minneapolis, MN 55417-2309 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 18/07/2007 |