Individual
ELDON SODERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2040 DOUGLAS DR N, SUITE 203, GOLDEN VALLEY, MN 55422-3944
(763) 925-9566
(763) 544-2180
Mailing address
2040 DOUGLAS DR N, SUITE 203, GOLDEN VALLEY, MN 55422-3944
(763) 925-9566
(763) 544-2180
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1821
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035J9SO
MN BCBS
MN
01
—
123593400
US DEPT OF LABOR
MN
05
—
173205
—
MN
05
—
370085200
—
MN
01
—
6401945
MEDICA
MN
Enumeration date
09/25/2006
Last updated
07/09/2007
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