Provider Demographics
NPI:1982726519
Name:KHALSA, SAT SIRI K (DC)
Entity Type:Individual
Prefix:DR
First Name:SAT SIRI
Middle Name:K
Last Name:KHALSA
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 1:509 W PUEBLO DR
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2508
Mailing Address - Country:US
Mailing Address - Phone:505-753-5640
Mailing Address - Fax:
Practice Address - Street 1:509 W PUEBLO DR
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2508
Practice Address - Country:US
Practice Address - Phone:505-753-5640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor