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Individual

DR. JULIE ANN BANTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT, FAAOMPT

Contact information

Practice address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 612-2464
Mailing address
1060 W PERIMETER RD, JB ANDREWS, MD 20762-6602
(240) 612-2464

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P15518
NC
225100000X
Physical Therapist
Primary
P15518
NC

Other

Enumeration date
03/27/2015
Last updated
05/05/2026
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