Individual
MRS. SHANDA RENAE KOEHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2601 CENTRAL AVE, SUITE 22, DODGE CITY, KS 67801-6200
(620) 227-9902
(620) 227-9932
Mailing address
2601 CENTRAL AVE, SUITE 22, DODGE CITY, KS 67801-6200
(620) 227-9902
(620) 227-9932
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-04848
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062037
INDIVIDUAL BC/MC ID #
KS
01
—
P00116509
RAILROAD MC ID #
KS
Enumeration date
09/27/2006
Last updated
03/12/2014
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