Provider Demographics
NPI:1043674047
Name:STUDEBAKER, SARAH JANE (LAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:STUDEBAKER
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 1:83 E OLENTANGY ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9277
Mailing Address - Country:US
Mailing Address - Phone:614-542-9658
Mailing Address - Fax:
Practice Address - Street 1:83 E OLENTANGY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9277
Practice Address - Country:US
Practice Address - Phone:614-542-9658
Practice Address - Fax:740-524-4200
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000254171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist