Basic Information
Provider Information
NPI: 1194945899
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOLON
FirstName: JILL
MiddleName: ELIZABETH
NamePrefix: MRS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 STANLEY GAULT PKWY STE 129
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402235176
CountryCode: US
TelephoneNumber: 5022534914
FaxNumber: 5024895751
Practice Location
Address1: 750 CYPRESS STATION DR
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402075142
CountryCode: US
TelephoneNumber: 5028963900
FaxNumber: 5025151263
Other Information
ProviderEnumerationDate: 04/26/2007
LastUpdateDate: 12/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X003428KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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