Provider Demographics
NPI:1639438278
Name:SMIRNOVA, SARAH C (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:C
Last Name:SMIRNOVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:COUET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6360 JACKSON RD STE F
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9597
Mailing Address - Country:US
Mailing Address - Phone:734-369-9990
Mailing Address - Fax:734-661-0784
Practice Address - Street 1:6360 JACKSON RD STE F
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9597
Practice Address - Country:US
Practice Address - Phone:734-369-9990
Practice Address - Fax:346-610-7847
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor