MEDICARE: RAMON A SOTO

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	111N00000X	Chiropractor	0104-557549	VA

General Provider Information

NPI Number	:	1104384940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMON A SOTO

Provider Business Mailing Address
First Line	:	5990 RICHMOND HWY APT 1019
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2752
Country	:	US
Telephone Number	:	928-919-0052
Fax Number	:

Provider Business Practice Location Address
First Line	:	5990 RICHMOND HWY APT 1019
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2752
Country	:	US
Telephone Number	:	928-919-0052
Fax Number	:

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

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/11/2019

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Directions to “ RAMON A SOTO ” Practice Location

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