Provider Demographics
NPI:1063664142
Name:SLAWTER, LORETTA A
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:A
Last Name:SLAWTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4339
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80866-4339
Mailing Address - Country:US
Mailing Address - Phone:719-492-0344
Mailing Address - Fax:
Practice Address - Street 1:321 W HENRIETTA AVE STE E
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3145
Practice Address - Country:US
Practice Address - Phone:719-492-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor