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1205519196
JACKIE SOTO
PROVO, UT
NPI
1205519196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: UT 13453257-2401)
Enumeration Date
2023-08-08
Last Update Date
2023-08-08
Business Address
JACKIE SOTO PT, DPT
1825 S EAST BAY BLVD
PROVO, UT 84606-5530
Phone number: 303-434-3770
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Mailing Address
JACKIE SOTO PT, DPT
794 E 700 N
SPANISH FORK, UT 84660-1646
Phone number: 303-434-3770
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