Provider Demographics
NPI:1154819399
Name:TRIMBLE, SARA (DC, LMT)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:DC, LMT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:FREELANDVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47535-0258
Mailing Address - Country:US
Mailing Address - Phone:812-486-9298
Mailing Address - Fax:
Practice Address - Street 1:301 E STATE ROAD 58
Practice Address - Street 2:
Practice Address - City:EDWARDSPORT
Practice Address - State:IN
Practice Address - Zip Code:47528-8178
Practice Address - Country:US
Practice Address - Phone:812-486-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003066A111NP0017X, 111N00000X
MO2016010644225700000X
INMT21605745225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist