Individual provider · Type 1 NPI

Sol Johanna Jaque, PTA

Physical Therapy Assistant · Lake Havasu City, AZ

NPI number 1750153615 Active

Practice location

191 Swanson Ave Ste 102
Lake Havasu City, AZ 86403-6699

Specialties and licenses

Taxonomy	Code	License
Physical Therapy Assistant Primary	225200000X	PTA-014722 (AZ)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1750153615

Sol Johanna Jaque, PTA's National Provider Identifier is 1750153615, issued on Oct 24, 2023. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Lake Havasu City, AZ. The record was last updated on Oct 24, 2023.