Provider Demographics
NPI:1528037769
Name:WILKIE, SARAH (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:WILKIE
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 1:601 WOODLAWN DR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-3503
Mailing Address - Country:US
Mailing Address - Phone:760-450-6043
Mailing Address - Fax:404-973-0188
Practice Address - Street 1:601 WOODLAWN DR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-3503
Practice Address - Country:US
Practice Address - Phone:760-450-6043
Practice Address - Fax:404-973-0188
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC29910Medicare ID - Type UnspecifiedID#