Healthcare Provider Details

I. General information

NPI: 1356971535
Provider Name (Legal Business Name): SLATER SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 WEALTHY ST SE
GRAND RAPIDS MI
49506-3011
US

IV. Provider business mailing address

2045 WEALTHY ST SE
GRAND RAPIDS MI
49506-3011
US

V. Phone/Fax

Practice location:
  • Phone: 616-901-6378
  • Fax:
Mailing address:
  • Phone: 616-901-6378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: LAURA K SLATER
Title or Position: PRESIDENT
Credential: LM, CPM
Phone: 616-901-6378