Provider Demographics
NPI:1508009317
Name:SOLEUS PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:SOLEUS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:626-744-9222
Mailing Address - Street 1:PO BOX 60498
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6498
Mailing Address - Country:US
Mailing Address - Phone:626-744-9222
Mailing Address - Fax:626-744-9229
Practice Address - Street 1:345 S LAKE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5030
Practice Address - Country:US
Practice Address - Phone:626-744-9222
Practice Address - Fax:626-744-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty