Provider Demographics
NPI:1215397609
Name:SPARKS, RACHEL (DC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GIRRENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7829 E ROCKHILL ST
Mailing Address - Street 2:303
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3920
Mailing Address - Country:US
Mailing Address - Phone:316-854-3010
Mailing Address - Fax:316-854-1029
Practice Address - Street 1:7829 E ROCKHILL ST
Practice Address - Street 2:303
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-854-3010
Practice Address - Fax:316-854-1029
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor