Individual
WILMER I SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
DT28 CALLE LAGO ICACO, 5TALEVITTOWN, TOA BAJA, PR 00949-3529
(787) 633-2704
Mailing address
DT28 CALLE LAGO ICACO, 5TALEVITTOWN, TOA BAJA, PR 00949-3529
(787) 633-2704
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
301
PR
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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