Healthcare Provider Details

I. General information

NPI: 1013211127
Provider Name (Legal Business Name): SOTER HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 INTERLACHEN BAY
WOODBURY MN
55125-9185
US

IV. Provider business mailing address

1752 INTERLACHEN BAY
WOODBURY MN
55125-9185
US

V. Phone/Fax

Practice location:
  • Phone: 612-924-3030
  • Fax:
Mailing address:
  • Phone: 612-924-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID LESLIE MAIR
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 612-924-3030