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General NPI Number Information
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NPI Number | 1003383035
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Entity Type | Individual
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Provider Name | SOLEDAD POQUIZ PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 1011 OLD U.S. 27 SUITE A
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City | ST. JOHNS
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State | MI
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Zip | 48879
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Country | US
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Telephone | 989-224-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 209 PURDY DR
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City | ALMA
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State | MI
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Zip | 48801-2160
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Country | US
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Telephone | 989-331-4022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1588642110
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License Number State | MI
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