Individual
DR. PHYLLIS M SOLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1289 E LIVINGSTON AVE, COLUMBUS, OH 43205-2838
(614) 252-1173
(614) 253-2053
Mailing address
1289 E LIVINGSTON AVE, COLUMBUS, OH 43205-2838
(614) 252-1173
(614) 253-2053
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3289
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0334481
—
OH
01
—
311016335026
CARESOURCE
OH
Enumeration date
01/24/2007
Last updated
11/13/2011
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