Provider Demographics
NPI:1922284454
Name:SLUPPICK, SARO WILLIAM (CO)
Entity Type:Individual
Prefix:MR
First Name:SARO
Middle Name:WILLIAM
Last Name:SLUPPICK
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:748 WALNUT KNOLL LN
Mailing Address - Street 2:SUITE 2&3
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3110
Mailing Address - Country:US
Mailing Address - Phone:901-737-5738
Mailing Address - Fax:901-737-5692
Practice Address - Street 1:748 WALNUT KNOLL LN
Practice Address - Street 2:SUITE 2&3
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3110
Practice Address - Country:US
Practice Address - Phone:901-737-5738
Practice Address - Fax:901-737-5692
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT0000000090222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist