Provider Demographics
NPI:1679915722
Name:FIRMAGE, SARAH E (LAC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:FIRMAGE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3267 E 3300 S # 138
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2246
Mailing Address - Country:US
Mailing Address - Phone:801-448-2503
Mailing Address - Fax:
Practice Address - Street 1:210 E MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:UT
Practice Address - Zip Code:84049-6828
Practice Address - Country:US
Practice Address - Phone:435-657-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT365081-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist