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General NPI Number Information
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NPI Number | 1760663223
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Entity Type | Organization
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Legal Business Name | SLAKMAN CHIROPRACTIC
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 2900 PETERS CREEK RD
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City | ROANOKE
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State | VA
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Zip | 24019-3514
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Country | US
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Telephone | 540-562-3100
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Fax | 540-562-2101
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Provider Business Mailing Address
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Address Line | 2900 PETERS CREEK RD
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City | ROANOKE
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State | VA
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Zip | 24019-3514
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Country | US
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Telephone | 540-562-3100
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Fax | 540-562-2101
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN SCOTT SLAKMAN
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Credential |
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Telephone | 540-562-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0104001534
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License Number State | VA
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