Provider Demographics
NPI:1629177183
Name:SAUER, SHANNON STERLING (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:STERLING
Last Name:SAUER
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 1:316 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:KS
Mailing Address - Zip Code:67579-2319
Mailing Address - Country:US
Mailing Address - Phone:620-278-3800
Mailing Address - Fax:620-278-3801
Practice Address - Street 1:316 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:KS
Practice Address - Zip Code:67579-1616
Practice Address - Country:US
Practice Address - Phone:620-278-3800
Practice Address - Fax:620-278-3801
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS23872OtherBLUE CROSS/ BLUE SHIELD
KSU38393Medicare UPIN