Healthcare Provider Details

I. General information

NPI: 1508955238
Provider Name (Legal Business Name): TYLER J SLINEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 GEORGE WASHINGTON HWY BUILDING C SUITE 102
LINCOLN RI
02865
US

IV. Provider business mailing address

640 GEORGE WASHINGTON HWY BUILDING C SUITE 102
LINCOLN RI
02865
US

V. Phone/Fax

Practice location:
  • Phone: 401-305-7960
  • Fax: 401-305-7961
Mailing address:
  • Phone: 401-305-7960
  • Fax: 401-305-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP 00551
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: