Provider Demographics
NPI:1306029905
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 1:3208 STAMFORD RD
Mailing Address - Street 2:STE 44
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703
Mailing Address - Country:US
Mailing Address - Phone:757-483-3390
Mailing Address - Fax:757-483-3617
Practice Address - Street 1:3208 STAMFORD RD
Practice Address - Street 2:STE 44
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703
Practice Address - Country:US
Practice Address - Phone:757-483-3390
Practice Address - Fax:757-483-3617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLONE CHIROPRACTIC CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty