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General NPI Number Information
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NPI Number | 1285836577
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Entity Type | Individual
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Provider Name | CAROLYN SUE SLOTE P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1401 S J ST
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City | FORT SMITH
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State | AR
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Zip | 72901-5158
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Country | US
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Telephone | 479-785-3300
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Fax | 479-785-8516
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Provider Business Mailing Address
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Address Line | 3808 S 24TH ST
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City | FORT SMITH
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State | AR
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Zip | 72901-7401
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Country | US
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Telephone | 479-646-0459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 899
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License Number State | AR
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