Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 01-04237 | KS |
NPI | 1033218052 |
---|---|
Provider Name | Dr. Shirley Fay Sagerty |
First Address | Wichita, KS 67220-3959 |
Second Address | Wichita, KS 67220-3959 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 05/12/2016 |