Individual
DR. SHANNON SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC, CKTP
Contact information
Practice address
121 W MAIN ST, SEDAN, KS 67361-1511
(620) 725-3005
Mailing address
121 W MAIN ST, SEDAN, KS 67361-1511
(620) 725-3005
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5194
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KA1142
MEDICARE PTAN
—
Enumeration date
05/21/2008
Last updated
10/26/2022
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