Provider Demographics
NPI:1982166732
Name:SANDERS, KRISTA MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:MICHELLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 79TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2211
Mailing Address - Country:US
Mailing Address - Phone:806-701-5432
Mailing Address - Fax:
Practice Address - Street 1:2507 79TH ST STE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2211
Practice Address - Country:US
Practice Address - Phone:806-701-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor