Provider Demographics
NPI:1730924655
Name:LANDWEHR, SADIE ALYSSA (DC)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:ALYSSA
Last Name:LANDWEHR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11814 W ALDERNY CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6555
Mailing Address - Country:US
Mailing Address - Phone:316-347-0540
Mailing Address - Fax:
Practice Address - Street 1:4041 N MAIZE RD STE 220
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-8901
Practice Address - Country:US
Practice Address - Phone:316-295-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor