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General NPI Number Information
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NPI Number | 1376161638
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Entity Type | Individual
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Provider Name | MOLLY SOTO DPT
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 9 N EUCLID AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1567
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Country | US
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Telephone | 314-566-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 9 N EUCLID AVE UNIT 613
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1484
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Country | US
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Telephone | 314-566-1540
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 070.025209
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2021006417
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License Number State | MO
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