Provider Demographics
NPI:1407148521
Name:SLONAKER, JOHN E (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:SLONAKER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 INDEPENDENCE PKWY
Mailing Address - Street 2:APARTMENT 421
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-8201
Mailing Address - Country:US
Mailing Address - Phone:301-219-0312
Mailing Address - Fax:
Practice Address - Street 1:10200 INDEPENDENCE PKWY
Practice Address - Street 2:APARTMENT 421
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-8201
Practice Address - Country:US
Practice Address - Phone:301-219-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-08
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1201269225100000X
PAPT021229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist