Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 009471-1 | NY |
NPI | 1134872708 |
---|---|
Provider Name | Will Steven Soles |
First Address | Rochester, NY 14618-1030 |
Second Address | Rochester, NY 14626-4164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2022 |
Last Update Date | 02/02/2022 |