Provider Demographics
NPI:1134468382
Name:FLICKINGER, SARA NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:NICOLE
Last Name:FLICKINGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:NICOLE
Other - Last Name:RIEKENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:210 E FRONTVIEW ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-5071
Mailing Address - Country:US
Mailing Address - Phone:620-371-6166
Mailing Address - Fax:620-371-6371
Practice Address - Street 1:210 E FRONTVIEW ST
Practice Address - Street 2:SUITE C
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-5071
Practice Address - Country:US
Practice Address - Phone:620-371-6166
Practice Address - Fax:620-371-6371
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor