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General NPI Number Information
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NPI Number | 1932382389
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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 | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2469 PRUDEN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434
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Country | US
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Telephone | 757-539-4100
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Fax | 757-539-9187
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Provider Business Mailing Address
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Address Line | 111 W. VIRGINIA BEACH BLVD.
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City | NORFOLK
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State | VA
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Zip | 23510-2005
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Country | US
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Telephone | 757-623-7776
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Fax | 757-623-1522
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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 | 0104001887
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License Number State | VA
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