Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 6152 | SC |
NPI | 1003131426 |
---|---|
Provider Name | Caitlyn Esther Soltes |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29601-2629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 11/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TH2221 | (05) | SC |