MEDICARE: ERIN MARIE SLIVKA DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	11-03737	KS
2	225100000X	Physical Therapist	2010038793	MO

General Provider Information

NPI Number	:	1023396108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MARIE SLIVKA DPT

Provider Business Mailing Address
First Line	:	15010 CRAIG ST
Second Line	:
City	:	BASEHOR
State	:	KS
Zip	:	66007-9716
Country	:	US
Telephone Number	:	913-269-6120
Fax Number	:

Provider Business Practice Location Address
First Line	:	6349 FARTHING DR
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80906-7504
Country	:	US
Telephone Number	:	913-269-6120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2011
Last Update Date	:	01/17/2019

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