Provider Demographics
NPI:1386941979
Name:FLICKINGER, SHAUNNON J (DC)
Entity type:Individual
Prefix:DR
First Name:SHAUNNON
Middle Name:J
Last Name:FLICKINGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 STEAMBOAT DR
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-7409
Mailing Address - Country:US
Mailing Address - Phone:620-390-9707
Mailing Address - Fax:
Practice Address - Street 1:210 E FRONTVIEW ST
Practice Address - Street 2:SUITE C
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-5071
Practice Address - Country:US
Practice Address - Phone:620-370-6166
Practice Address - Fax:620-371-6371
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor