Individual
SANDRA SOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 HIGHWAY 17 N, STE A, SURFSIDE BEACH, SC 29575-6012
(843) 238-9542
Mailing address
504 YORKTOWN CT, MYRTLE BEACH, SC 29579-3113
(843) 903-7932
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1738
LICENSE#
SC
Enumeration date
08/30/2006
Last updated
07/08/2007
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