Individual
ERIC SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5055 A ST STE 400A, LINCOLN, NE 68510-4957
(024) 483-4485
(402) 483-5372
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
POD-000905
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
376
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
04/09/2015
Last updated
01/22/2021
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