Provider Demographics
NPI:1629808142
Name:SOLANO, EDER (DPT)
Entity type:Individual
Prefix:
First Name:EDER
Middle Name:
Last Name:SOLANO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 S PURCELL BLVD # 116
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81007-5083
Mailing Address - Country:US
Mailing Address - Phone:719-527-0848
Mailing Address - Fax:719-471-4415
Practice Address - Street 1:279 S PURCELL BLVD # 116
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81007-5083
Practice Address - Country:US
Practice Address - Phone:719-527-0848
Practice Address - Fax:719-471-4415
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist