Provider Demographics
NPI:1710639760
Name:STANTON, SARAH LYNN (DC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:STANTON
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 1:302 HYDE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-7296
Mailing Address - Country:US
Mailing Address - Phone:314-606-1417
Mailing Address - Fax:
Practice Address - Street 1:1428 N STATE HIGHWAY 47 STE B
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1375
Practice Address - Country:US
Practice Address - Phone:636-456-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021050862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor