Provider Demographics
NPI:1891270229
Name:SLONAKER ENTERPRISES, LLC
Entity type:Organization
Organization Name:SLONAKER ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:SLONAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-293-1703
Mailing Address - Street 1:2691 N LARCHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6093
Mailing Address - Country:US
Mailing Address - Phone:509-293-1703
Mailing Address - Fax:
Practice Address - Street 1:3329 W CHERRY LN
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1119
Practice Address - Country:US
Practice Address - Phone:509-293-1703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty