Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA18899 | FL |
NPI | 1003343534 |
---|---|
Provider Name | Michael Sohr |
First Address | Hollywood, FL 33019-1531 |
Second Address | Plantation, FL 33324-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2017 |
Last Update Date | 15/05/2017 |