Individual
CHARLES L SLAUGHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
820 COOPER RD, SUITE J, JACKSON, MS 39212-4099
(601) 372-9229
(601) 372-9990
Mailing address
PO BOX 7296, JACKSON, MS 39282-7296
(601) 372-9229
(601) 372-9990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0161
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00489050
—
MS
Enumeration date
12/13/2006
Last updated
07/08/2007
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