Individual
KIMBERLY SODERHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
109 3RD ST E, ECSE LODEON CENTER, WEST FARGO, ND 58078-1817
(701) 356-2115
Mailing address
109 3RD ST E, ECSE LODEON CENTER, WEST FARGO, ND 58078-1817
(701) 356-2115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
800
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50095
—
ND
Enumeration date
03/14/2008
Last updated
03/14/2008
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