Provider Demographics
NPI:1215975032
Name:SOLOMON, LINDA (DC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7388 FENTON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8963
Mailing Address - Country:US
Mailing Address - Phone:616-916-1616
Mailing Address - Fax:
Practice Address - Street 1:7388 FENTON RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8963
Practice Address - Country:US
Practice Address - Phone:616-916-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002969L111N00000X
MI2301009540111N00000X
DCCH030108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075658Medicare ID - Type Unspecified