Provider Demographics
NPI:1710374244
Name:KO & SLAUGHTER CHIROPRACTIC
Entity Type:Organization
Organization Name:KO & SLAUGHTER CHIROPRACTIC
Other - Org Name:CHIROBALANCE SPINE & SPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-329-7774
Mailing Address - Street 1:223 W MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-6842
Mailing Address - Country:US
Mailing Address - Phone:408-329-7774
Mailing Address - Fax:408-752-2721
Practice Address - Street 1:223 W MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-6842
Practice Address - Country:US
Practice Address - Phone:408-329-7774
Practice Address - Fax:408-752-2721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty