Provider Demographics
NPI:1457471237
Name:PLANTILLA, EDUARDO SOLIMAN (PT)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:SOLIMAN
Last Name:PLANTILLA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-1380
Mailing Address - Country:US
Mailing Address - Phone:802-864-3785
Mailing Address - Fax:802-864-0274
Practice Address - Street 1:321 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-1380
Practice Address - Country:US
Practice Address - Phone:802-864-3785
Practice Address - Fax:802-864-0274
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0003678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist