MEDICARE: MRS. SHAGUN SODHI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1197943	TX

General Provider Information

NPI Number	:	1033416904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAGUN SODHI DPT

Provider Business Mailing Address
First Line	:	3644 GLENBARRY CIR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-2604
Country	:	US
Telephone Number	:	919-602-7189
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 CORAL RIDGE DR STE 120
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3388
Country	:	US
Telephone Number	:	866-425-5768
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2011
Last Update Date	:	02/11/2011

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