Provider Demographics
NPI:1689818437
Name:SLOTE, BAYLEN K (LAC)
Entity Type:Individual
Prefix:MR
First Name:BAYLEN
Middle Name:K
Last Name:SLOTE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 205
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667
Mailing Address - Country:US
Mailing Address - Phone:802-322-5005
Mailing Address - Fax:802-322-5005
Practice Address - Street 1:53 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667
Practice Address - Country:US
Practice Address - Phone:802-322-5005
Practice Address - Fax:802-322-5005
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12813171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist