Provider Demographics
NPI:1740430651
Name:PETERS, SARAH MAE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MAE
Last Name:PETERS
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 1:6982 ALPINE TRL
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-3739
Mailing Address - Country:US
Mailing Address - Phone:612-203-1318
Mailing Address - Fax:
Practice Address - Street 1:6982 ALPINE TRL
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-3739
Practice Address - Country:US
Practice Address - Phone:612-203-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4380111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician