Healthcare Provider Details

I. General information

NPI: 1538567557
Provider Name (Legal Business Name): KAREN TAYLOR SOILES PT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 PROVIDENCE HWY STE LOWER6
DEDHAM MA
02026-6811
US

IV. Provider business mailing address

20 DONCASTER ST
BOSTON MA
02131-4610
US

V. Phone/Fax

Practice location:
  • Phone: 703-646-0313
  • Fax:
Mailing address:
  • Phone: 703-646-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2305204518
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN TAYLOR SOILES
Title or Position: OWNER
Credential: PT
Phone: 703-477-9454