Provider Demographics
NPI:1710378823
Name:SHEAHON, KYLE (DC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:SHEAHON
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 1:1081 S OHIO ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5364
Mailing Address - Country:US
Mailing Address - Phone:785-827-0354
Mailing Address - Fax:785-823-5101
Practice Address - Street 1:1081 S OHIO ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5364
Practice Address - Country:US
Practice Address - Phone:785-827-0354
Practice Address - Fax:785-823-5101
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-04144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor