Provider Demographics
NPI:1508425190
Name:SARA DENNISON DC LLC
Entity Type:Organization
Organization Name:SARA DENNISON DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-497-0780
Mailing Address - Street 1:38669 MENTOR AVE STE E
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7781
Mailing Address - Country:US
Mailing Address - Phone:440-497-0780
Mailing Address - Fax:
Practice Address - Street 1:38669 MENTOR AVE STE E
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7781
Practice Address - Country:US
Practice Address - Phone:440-497-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty