Provider Demographics
NPI:1538300769
Name:GIRARD, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GIRARD
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 1:2113 KONNOAK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-2953
Mailing Address - Country:US
Mailing Address - Phone:336-721-1559
Mailing Address - Fax:
Practice Address - Street 1:2113 KONNOAK VIEW DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-2953
Practice Address - Country:US
Practice Address - Phone:336-721-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC359171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist