Provider Demographics
NPI:1942635966
Name:ELASHKAR, SAM (DC, PHD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:
Last Name:ELASHKAR
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:SAM
Other - Last Name:ELASHKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, PHD
Mailing Address - Street 1:4714 BOOTH ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1825
Mailing Address - Country:US
Mailing Address - Phone:913-954-9380
Mailing Address - Fax:816-523-4623
Practice Address - Street 1:6301 ROCKHILL RD.,
Practice Address - Street 2:EMMANUEL CHIROPRACTIC CLINIC, SUITE 105
Practice Address - City:KC
Practice Address - State:MO
Practice Address - Zip Code:64131
Practice Address - Country:US
Practice Address - Phone:913-954-9380
Practice Address - Fax:816-523-4623
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002016565111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician