Individual
THEODORE NELLIS SLAHETKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 W 26TH ST, BARNEGAT LIGHT, NJ 08006-1424
(609) 651-1186
Mailing address
18 W 26TH ST, BARNEGAT LIGHT, NJ 08006-1424
(609) 651-1186
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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