Provider Demographics
NPI:1700376746
Name:CONNELLY, SARAH MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARGARET
Last Name:CONNELLY
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 1:500 S DAVIS ST STE B
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MO
Mailing Address - Zip Code:64644-1434
Mailing Address - Country:US
Mailing Address - Phone:816-583-2220
Mailing Address - Fax:816-447-3922
Practice Address - Street 1:500 S DAVIS ST STE B
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MO
Practice Address - Zip Code:64644-1434
Practice Address - Country:US
Practice Address - Phone:816-583-2220
Practice Address - Fax:816-447-3922
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018015769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor