Provider Demographics
NPI:1396376638
Name:FENSKE, SAWYER GUY (DC)
Entity Type:Individual
Prefix:
First Name:SAWYER
Middle Name:GUY
Last Name:FENSKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87913 HIGHWAY 281
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-4637
Mailing Address - Country:US
Mailing Address - Phone:308-215-8080
Mailing Address - Fax:
Practice Address - Street 1:304 E DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1830
Practice Address - Country:US
Practice Address - Phone:402-336-4222
Practice Address - Fax:402-336-4228
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor