MEDICARE: CHAD SOYKIN

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	225200000X	Physical Therapy Assistant	2012025746	MO

General Provider Information

NPI Number	:	1538739362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD SOYKIN

Provider Business Mailing Address
First Line	:	3806 N BARRINGTON CT
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-4184
Country	:	US
Telephone Number	:	314-341-0903
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 N OLD ORCHARD AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-2699
Country	:	US
Telephone Number	:	314-266-1024
Fax Number	:

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

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	06/24/2021

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Directions to “ CHAD SOYKIN ” Practice Location

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