Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | P10319 | NC |
NPI | 1285094730 |
---|---|
Provider Name | Rommel Soriano |
First Address | Dunn, NC 28334-6806 |
Second Address | Pollocksville, NC 28573-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2016 |
Last Update Date | 26/02/2016 |