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Organization
MARK SLAUGHTER PC
Active
Organization
MARK SLAUGHTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SLAUGHTER P. T. (PHYSICAL THERAPIST OWNER)
(618) 656-5433
Entity
Organization
Contact information
Practice address
219 2ND AVE, SUITE C, EDWARDSVILLE, IL 62025-2556
(618) 656-5433
(618) 656-5437
Mailing address
219 2ND AVE, SUITE C, EDWARDSVILLE, IL 62025-2556
(618) 656-5433
(618) 656-5437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06032038
BLUE CROSS BLUE SHIELD
IL
01
—
167276
BLUE CROSS BLUE SHIELD
MO
01
—
4650113
AETNA
IL
01
—
514168
HEALTHLINK
IL
01
—
64-00479
UNITED HEALTHCARE
IL
Enumeration date
04/03/2007
Last updated
02/01/2008
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