Provider Demographics
NPI:1285657700
Name:SOLAN, JOHN R (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SOLAN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VETERANS ADMINISTRATION MEDICAL CENTER
Mailing Address - Street 2:4801 VETERANS DRIVE
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-255-6370
Mailing Address - Fax:
Practice Address - Street 1:VETERANS ADMINISTRATION MEDICAL CENTER
Practice Address - Street 2:4801 VETERANS DRIVE
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-255-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA 01224231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist