# ANDREW I SOLOMON DC SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063546851
- **Authorized official:** DR. ANDREW IRA SOLOMON DC (OWNER)
- **Authorized official phone:** (262) 552-7999

## Contact information

- **Practice address:** 4401 TAYLOR AVENUE, RACINE, WI 53405-4679
- **Practice address phone:** (262) 552-7999
- **Practice address fax:** (262) 552-7998
- **Mailing address:** 4401 TAYLOR AVENUE, RACINE, WI 53405-4679
- **Mailing address phone:** (262) 552-7999
- **Mailing address fax:** (262) 552-7998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1406012 | WI | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 088387499002 | BLUE CROSS | WI |
| 05 | — | 38752300 | — | WI |