Healthcare Provider Details

I. General information

NPI: 1992907448
Provider Name (Legal Business Name): SLIGH CLINIC OF CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 S FLORIDA AVE
LAKELAND FL
33801-5226
US

IV. Provider business mailing address

PO BOX 873
LAKELAND FL
33802-0873
US

V. Phone/Fax

Practice location:
  • Phone: 863-686-4149
  • Fax: 863-683-4888
Mailing address:
  • Phone: 863-686-4149
  • Fax: 863-683-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN EUGENE SLIGH
Title or Position: OWNER
Credential: D.C.
Phone: 863-686-4149