Provider Demographics
NPI:1558486480
Name:KERSTEN, SARA MARIE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:KERSTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:PFEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1417 CANAL DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5812
Mailing Address - Country:US
Mailing Address - Phone:303-539-6919
Mailing Address - Fax:
Practice Address - Street 1:4605 ZIEGLER RD UNIT 1
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3089
Practice Address - Country:US
Practice Address - Phone:970-223-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801977Medicare ID - Type UnspecifiedMEDICARE #