Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 01-04679 | KS |
N | 111NS0005X | Chiropractic Sports Physician | 01-04679 | KS |
NPI | 1124453196 |
---|---|
Provider Name | Dr. Michael Sean Felton |
First Address | Wichita, KS 67212-3323 |
Second Address | Wichita, KS 67212-3323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2013 |
Last Update Date | 10/09/2013 |