Provider Demographics
NPI:1376710384
Name:SLOTA, KAREN MICHAELA (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MICHAELA
Last Name:SLOTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 W 14 MILE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1710
Mailing Address - Country:US
Mailing Address - Phone:248-919-9696
Mailing Address - Fax:
Practice Address - Street 1:2605 W 14 MILE RD STE 220
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-1710
Practice Address - Country:US
Practice Address - Phone:248-919-9696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M94480Medicare PIN