Provider Demographics
NPI:1851621544
Name:SLABAUGH, JESSICA RICHARDSON (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RICHARDSON
Last Name:SLABAUGH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16425 GRAPPERHALL DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-8753
Mailing Address - Country:US
Mailing Address - Phone:269-760-7980
Mailing Address - Fax:
Practice Address - Street 1:9718 SAM FURR RD UNIT D
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4929
Practice Address - Country:US
Practice Address - Phone:704-896-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor