| Slt Medical Group Inc | |
|
2024 Lake Tahoe Blvd South Lake Tahoe CA 96150-6498 | |
| (406) 334-7470 | |
| Not Available |
| Full Name | Slt Medical Group Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 2024 Lake Tahoe Blvd, South Lake Tahoe, California |
| Authorized Official Name and Position | Edwin Emmanuel Nebblett (CEO) |
| Authorized Official Contact | 5756545188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Slt Medical Group Inc Po Box 910 Weimar CA 95736-0910 Ph: (575) 654-5188 | Slt Medical Group Inc 2024 Lake Tahoe Blvd South Lake Tahoe CA 96150-6498 Ph: (406) 334-7470 |
| NPI Number | 1902435894 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 04/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902435894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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