Provider Demographics
NPI:1851831804
Name:SOTO, JOSE (DPT, PT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:SOTO
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1292 HILLOCK XING
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6700
Mailing Address - Country:US
Mailing Address - Phone:757-470-8240
Mailing Address - Fax:
Practice Address - Street 1:8250 GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4902
Practice Address - Country:US
Practice Address - Phone:703-388-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist