Individual
SANDRA SODERBERG
Active
Individual
SANDRA SODERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1353
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036J0SO
MN BCBS
MN
01
—
123593400
US DEPT OF LABOR
MN
05
—
173205
—
MN
05
—
289017800
—
MN
01
—
641948
MEDICA
MN
Enumeration date
09/25/2006
Last updated
07/09/2007
Update your record
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