Provider Demographics
NPI:1548605439
Name:SOLAN, SHELLY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:LYNN
Last Name:SOLAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:LYNN
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:350 STONECROFT LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-0521
Mailing Address - Country:US
Mailing Address - Phone:984-974-6083
Mailing Address - Fax:984-974-6096
Practice Address - Street 1:350 STONECROFT LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-0521
Practice Address - Country:US
Practice Address - Phone:984-974-6083
Practice Address - Fax:984-974-6096
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist