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NPI Code Detail

MEDICARE: JOHN SOTORA PTA

MEDICARE: JOHN SOTORA PTA
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
1225200000XPhysical Therapy Assistant06529OH

General Provider Information

NPI Number : 1477784619
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SOTORA PTA
Provider Business Mailing Address
First Line : 225 W MAIN ST
Second Line :
City : SHELBY
State : OH
Zip : 44875-1412
Country : US
Telephone Number : 419-347-1503
Fax Number : 419-347-1503
Provider Business Practice Location Address
First Line : 225 W MAIN ST
Second Line :
City : SHELBY
State : OH
Zip : 44875-1412
Country : US
Telephone Number : 419-347-1503
Fax Number : 419-347-1503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2009
Last Update Date : 08/06/2009

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