Provider Demographics
NPI:1932382389
Name:SLONE CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:SLONE CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-623-7776
Mailing Address - Street 1:111 W. VIRGINIA BEACH BLVD.
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2005
Mailing Address - Country:US
Mailing Address - Phone:757-623-7776
Mailing Address - Fax:757-623-1522
Practice Address - Street 1:2469 PRUDEN BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-539-4100
Practice Address - Fax:757-539-9187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLONE CHIROPRACTIC CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty