Provider Demographics
NPI:1689125056
Name:PAGE, SARAH (DC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PAGE
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 1:1972 RIDGEDALE AVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-4011
Mailing Address - Country:US
Mailing Address - Phone:952-818-6183
Mailing Address - Fax:
Practice Address - Street 1:31 NAVAHO AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4812
Practice Address - Country:US
Practice Address - Phone:507-345-4035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor