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General NPI Number Information
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NPI Number | 1306029905
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Entity Type | Organization
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Legal Business Name | SLONE CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 3208 STAMFORD RD STE 44
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City | PORTSMOUTH
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State | VA
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Zip | 23703
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Country | US
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Telephone | 757-483-3390
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Fax | 757-483-3617
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Provider Business Mailing Address
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Address Line | 3208 STAMFORD RD STE 44
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City | PORTSMOUTH
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State | VA
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Zip | 23703
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Country | US
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Telephone | 757-483-3390
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Fax | 757-483-3617
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Authorized Official
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Title or Position | OWNER
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Name | LONNIE A SLONE
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Credential | DC
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Telephone | 757-623-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104000993
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License Number State | VA
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