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General NPI Number Information
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NPI Number | 1891270229
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Entity Type | Organization
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Legal Business Name | SLONAKER ENTERPRISES, LLC
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 10/02/2018
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Provider Practice Location Address
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Address Line | 3329 W CHERRY LN
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City | MERIDIAN
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State | ID
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Zip | 83642-1119
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Country | US
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Telephone | 509-293-1703
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Fax |
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Provider Business Mailing Address
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Address Line | 2691 N LARCHMONT AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-6093
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Country | US
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Telephone | 509-293-1703
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. KURT FREDERICK SLONAKER
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Credential | DC
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Telephone | 509-293-1703
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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 |
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License Number State |
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