Provider Demographics
NPI:1568150670
Name:SOLANO SPORTS PHYSICAL THERAPY & TRAINING, INC.
Entity Type:Organization
Organization Name:SOLANO SPORTS PHYSICAL THERAPY & TRAINING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JUHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:707-449-3484
Mailing Address - Street 1:1350 BURTON DR STE 260
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3545
Mailing Address - Country:US
Mailing Address - Phone:707-449-3484
Mailing Address - Fax:707-449-1803
Practice Address - Street 1:1350 BURTON DR STE 260
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3545
Practice Address - Country:US
Practice Address - Phone:707-449-3484
Practice Address - Fax:707-449-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy