Individual
STACEY LEE SOLOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 E WEST HART RD, BELOIT, WI 53511-1816
(608) 628-2335
Mailing address
504 NEWVILLE ST, EDGERTON, WI 53534-1914
(608) 628-2335
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3151-19
WI
Other
Enumeration date
06/27/2021
Last updated
06/27/2021
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