Provider Demographics
NPI:1144838632
Name:FISCHER, SOOLMAZ ARJOMAND (DPT)
Entity type:Individual
Prefix:
First Name:SOOLMAZ
Middle Name:ARJOMAND
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932184
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-2184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2420 W ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6337
Practice Address - Country:US
Practice Address - Phone:432-687-0235
Practice Address - Fax:432-570-8713
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35776225100000X
TN13102225100000X
TX1394835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist