John R Soderstrom, P.A.

NPI #1871506931 in Peoria, Illinois

Provider Information

NPI Number: 1871506931
Entity Type: Individual
Name: John R Soderstrom, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Aug 13, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 4909 N GLEN PARK PLACE RD
City: Peoria
State: Illinois
ZIP Code: 61614-4676
Phone: (309) 674-7546

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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