=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124264528
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY MARLENE SLINKARD D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2009
-----------------------------------------------------
Last Update Date | 06/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 36016 FIVE MILE RD
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48154-1918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-591-0404
-----------------------------------------------------
Fax | 734-591-1534
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26421 SOUTHFIELD RD
-----------------------------------------------------
City | LATHRUP VILLAGE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48076-4528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-905-5066
-----------------------------------------------------
Fax | 248-905-5069
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301229830
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------