Individual
BONNIE LYNN SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
194 THOMAS JOHNSON DR STE B, FREDERICK, MD 21702-4683
(301) 418-6434
Mailing address
163 THOMAS JOHNSON DR STE A, FREDERICK, MD 21702-4673
(240) 566-3187
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
9984
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12614874
CAQH
CA
Enumeration date
08/27/2012
Last updated
02/07/2022
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