Provider Demographics
NPI:1528410446
Name:STOCKER, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STOCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1536
Mailing Address - Country:US
Mailing Address - Phone:269-369-4850
Mailing Address - Fax:
Practice Address - Street 1:818 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1536
Practice Address - Country:US
Practice Address - Phone:269-369-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other