Basic Information
| Provider Information | |||||||||
| NPI: | 1144838632 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARJOMAND | ||||||||
| FirstName: | SOOLMAZ | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8888 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049158888 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012591645 | ||||||||
| FaxNumber: | 9012597648 | ||||||||
| Practice Location | |||||||||
| Address1: | 8040 WOLF RIVER BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015226440 | ||||||||
| FaxNumber: | 9017572507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2020 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT35776 | FL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 13102 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.