Provider Demographics
NPI:1346266327
Name:MALCHOW, SARA A (DC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:MALCHOW
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 1:412 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-6901
Mailing Address - Country:US
Mailing Address - Phone:605-336-1188
Mailing Address - Fax:605-336-2677
Practice Address - Street 1:412 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6901
Practice Address - Country:US
Practice Address - Phone:605-336-1188
Practice Address - Fax:605-336-2677
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4994653OtherBLUE CROSS/BLUE SHIELD
SD100468Medicare PIN
SD100467Medicare ID - Type UnspecifiedMEDICARE/GROUP