Provider Demographics
NPI:1649431123
Name:SLUTAK, JILL C (DC)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:C
Last Name:SLUTAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BRIARSDALE RD
Mailing Address - Street 2:STE C
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5900
Mailing Address - Country:US
Mailing Address - Phone:717-558-3500
Mailing Address - Fax:717-558-3505
Practice Address - Street 1:1000 BRIARSDALE RD
Practice Address - Street 2:STE C
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5900
Practice Address - Country:US
Practice Address - Phone:610-495-0101
Practice Address - Fax:610-495-0638
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor