| Organization Name: | SOAR PEDIATRIC THERAPY, LLC |
| NPI Number: | 1013314558 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE WEIMER (MEMBER/OWNER) |
| Mailing Address: | 1430 Newton St Sidney |
| State: | NE US |
| Postal Code: | 691621963 |
| Phone Number: | 3082251870 |
| Fax Number: | |
| NPI Enumeration Date: | 11/27/2014 |
| NPI Last Update Date: | 11/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 1850 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |