Provider Demographics
NPI:1689674152
Name:TEAGUE, SARAH M (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:TEAGUE
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 1:2385 LAKEVIEW DR
Mailing Address - Street 2:STE C
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3696
Mailing Address - Country:US
Mailing Address - Phone:937-426-0286
Mailing Address - Fax:937-426-5806
Practice Address - Street 1:2385 LAKEVIEW DR
Practice Address - Street 2:STE C
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3696
Practice Address - Country:US
Practice Address - Phone:937-426-0286
Practice Address - Fax:937-426-5806
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U57033Medicare UPIN
OH0676591Medicare ID - Type Unspecified