| Doctor Name: | JULIE A MOENTER |
| NPI Number: | 1023444965 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 50003909 |
| Business Practice Address: | 1178 Professional Dr Van Wert, OH - 458912461 |
| Business Phone Number: | 4192386251 |
| Business Fax Number: | 4192381652 |
| Mailing Address: | 1178 Professional Dr, VAN WERT |
| State: | OH |
| Postal Code: | 458912461 |
| Phone Number: | 4192386251 |
| Fax Number: | 4192381652 |
| NPI Enumeration Date: | 09/24/2013 |
| NPI Last Update Date: | 01/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 50003909 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |