Provider Demographics
NPI:1467504738
Name:SLOVER, ERIKA M (PT)
Entity Type:Individual
Prefix:MISS
First Name:ERIKA
Middle Name:M
Last Name:SLOVER
Suffix:
Gender:F
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:PO BOX 304
Mailing Address - Street 2:105 FRONTAGE RD., STE.F
Mailing Address - City:PEARCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85625-0304
Mailing Address - Country:US
Mailing Address - Phone:520-826-3222
Mailing Address - Fax:520-826-3222
Practice Address - Street 1:105 FRONTAGE RD., STE.F
Practice Address - Street 2:
Practice Address - City:PEARCE
Practice Address - State:AZ
Practice Address - Zip Code:85625
Practice Address - Country:US
Practice Address - Phone:520-826-3222
Practice Address - Fax:520-826-3222
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRPT 1500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ783078Medicaid
AZ783078Medicaid
R32516Medicare UPIN