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General NPI Number Information
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NPI Number | 1295460863
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Entity Type | Organization
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Legal Business Name | SOLANO SPINE & SPORT
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 803 W BROAD ST STE 620
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3133
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Country | US
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Telephone | 703-536-4366
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Fax | 703-536-7933
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Provider Business Mailing Address
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Address Line | 803 W BROAD ST STE 620
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3133
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Country | US
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Telephone | 703-536-4366
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Fax | 703-536-7933
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND SOLANO
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Credential |
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Telephone | 703-536-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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