Provider Demographics
NPI:1346865847
Name:PAUNICKA, SARAH (DC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PAUNICKA
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 1:580 N HIGHWAY 67 ST STE 5
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5130
Mailing Address - Country:US
Mailing Address - Phone:314-524-2580
Mailing Address - Fax:314-524-2596
Practice Address - Street 1:580 N HIGHWAY 67 ST STE 5
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5130
Practice Address - Country:US
Practice Address - Phone:314-524-2580
Practice Address - Fax:314-524-2596
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020015815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor