Provider Demographics
NPI:1740429299
Name:PRATER, SARAH JEANE (LAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEANE
Last Name:PRATER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 SANDIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-3502
Mailing Address - Country:US
Mailing Address - Phone:865-315-3845
Mailing Address - Fax:
Practice Address - Street 1:342 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5303
Practice Address - Country:US
Practice Address - Phone:865-315-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN297171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist