Provider Demographics
NPI:1023240363
Name:SOTO, EMILY JEAN (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:SOTO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:DZIRNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:580 FOREST AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1780
Mailing Address - Country:US
Mailing Address - Phone:734-673-8545
Mailing Address - Fax:734-545-8135
Practice Address - Street 1:580 FOREST AVE STE 1B
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1780
Practice Address - Country:US
Practice Address - Phone:734-673-8545
Practice Address - Fax:734-545-8135
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT8483225100000X
MI5501302293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist