Organization
SOL PHYSIOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISOL CARDOZA MENDOZA DPT (OWNER)
(208) 953-7057
Entity
Organization
Contact information
Practice address
804 N WHITLEY DR, FRUITLAND, ID 83619-2437
(208) 953-7057
Mailing address
6300 SE 4TH AVE, NEW PLYMOUTH, ID 83655-5447
(971) 409-6793
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
06/28/2020
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