Individual
ELIEZER SOLTEZ VIRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
18302 CONTOUR RD, MONTGOMERY VILLAGE, MD 20877-2614
(240) 912-2960
(301) 944-0097
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22997
MD
225100000X
Physical Therapist
9508
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97792224
VISA PASSPORT NUMBER
—
Enumeration date
11/02/2008
Last updated
08/08/2019
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