Provider Demographics
NPI:1477948925
Name:SOLDAN, JILLIAN MARY (DPT)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:MARY
Last Name:SOLDAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:JILLIAN
Other - Middle Name:MARY
Other - Last Name:KARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:403 HONEYBEE LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6794
Mailing Address - Country:US
Mailing Address - Phone:716-435-1654
Mailing Address - Fax:
Practice Address - Street 1:1008 MINNEQUA AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3733
Practice Address - Country:US
Practice Address - Phone:719-557-5817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0012479225100000X
SC12612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist