Provider Demographics
NPI:1790062008
Name:SAUER CHIROPRACTIC & SPORTS CLINIC INC
Entity Type:Organization
Organization Name:SAUER CHIROPRACTIC & SPORTS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:620-564-2555
Mailing Address - Street 1:6 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:67526-1638
Mailing Address - Country:US
Mailing Address - Phone:620-564-2555
Mailing Address - Fax:620-564-2711
Practice Address - Street 1:6 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLINWOOD
Practice Address - State:KS
Practice Address - Zip Code:67526-1638
Practice Address - Country:US
Practice Address - Phone:620-564-2555
Practice Address - Fax:620-564-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104026111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
014243Medicare PIN