Provider Demographics
NPI:1225261233
Name:MOORE, SARAH JEAN GALLE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEAN GALLE
Last Name:MOORE
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 1:4995 LACROSS RD
Mailing Address - Street 2:STE. 1000
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6542
Mailing Address - Country:US
Mailing Address - Phone:843-277-0889
Mailing Address - Fax:843-277-1628
Practice Address - Street 1:4995 LACROSS RD
Practice Address - Street 2:STE. 1000
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6542
Practice Address - Country:US
Practice Address - Phone:843-277-0889
Practice Address - Fax:843-277-1628
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3403111N00000X
IL038.011494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor