Provider Demographics
NPI:1366832818
Name:SKY CITY FAMILY CHIROPRACTIC, LLC.
Entity Type:Organization
Organization Name:SKY CITY FAMILY CHIROPRACTIC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUSEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-751-4975
Mailing Address - Street 1:1610 W KELLOGG DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209
Mailing Address - Country:US
Mailing Address - Phone:636-751-4975
Mailing Address - Fax:
Practice Address - Street 1:6810 W KELLOGG DR
Practice Address - Street 2:SUITE 150
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2275
Practice Address - Country:US
Practice Address - Phone:636-751-4975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty