Provider Demographics
NPI:1699272963
Name:SOLOMON, MEREDITH DAWN (LMT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:DAWN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8293 STATE ROUTE 776
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-8645
Mailing Address - Country:US
Mailing Address - Phone:740-288-6682
Mailing Address - Fax:
Practice Address - Street 1:1202 18TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2932
Practice Address - Country:US
Practice Address - Phone:740-356-7353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.012335225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist