Healthcare Provider Details

I. General information

NPI: 1396664249
Provider Name (Legal Business Name): SOLIS COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 OLD BRIDGE SITE RD
CASTLE HAYNE NC
28429-5044
US

IV. Provider business mailing address

6605 OLD BRIDGE SITE RD
CASTLE HAYNE NC
28429-5044
US

V. Phone/Fax

Practice location:
  • Phone: 910-524-7428
  • Fax:
Mailing address:
  • Phone: 910-524-7428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH CURTIS OWENS
Title or Position: MANAGING MEMBER
Credential:
Phone: 910-524-7428