Provider Demographics
NPI:1558494278
Name:SLAK CHIROPRACTIC GROUP
Entity Type:Organization
Organization Name:SLAK CHIROPRACTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EISEN-SLAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-273-0099
Mailing Address - Street 1:23 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4916
Mailing Address - Country:US
Mailing Address - Phone:781-273-0099
Mailing Address - Fax:781-273-3859
Practice Address - Street 1:23 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4916
Practice Address - Country:US
Practice Address - Phone:781-273-0099
Practice Address - Fax:781-273-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA950111N00000X
MA1235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT79827Medicare UPIN
MAU18997Medicare UPIN