Healthcare Provider Details

I. General information

NPI: 1649108002
Provider Name (Legal Business Name): NICK SLAYDON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 FISHER RD
MANY LA
71449-3710
US

IV. Provider business mailing address

PO BOX 127
MANY LA
71449-0127
US

V. Phone/Fax

Practice location:
  • Phone: 318-256-0660
  • Fax: 318-256-0661
Mailing address:
  • Phone: 337-239-3460
  • Fax: 318-256-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: