Healthcare Provider Details

I. General information

NPI: 1124184999
Provider Name (Legal Business Name): RAYMOND STEVEN SOLANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W BROAD ST SUITE #1B
FALLS CHURCH VA
22046-3204
US

IV. Provider business mailing address

502 W BROAD ST SUITE #1B
FALLS CHURCH VA
22046-3204
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-4366
  • Fax:
Mailing address:
  • Phone: 703-536-4366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556133
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: