Healthcare Provider Details

I. General information

NPI: 1225133028
Provider Name (Legal Business Name): SIDNEY ALLEN UNRUH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 S MERIDIAN AVE
VALLEY CENTER KS
67147-4951
US

IV. Provider business mailing address

PO BOX 70
VALLEY CENTER KS
67147-0070
US

V. Phone/Fax

Practice location:
  • Phone: 316-755-9797
  • Fax: 316-755-9798
Mailing address:
  • Phone: 316-249-7489
  • Fax: 316-755-9798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4627
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: