Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC16524 | CA |
NPI | 1285891515 |
---|---|
Provider Name | Patrick William Slavensky |
First Address | Sacramento, CA 95815-4314 |
Second Address | Sacramento, CA 95815-4314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 03/08/2011 |