Provider Demographics
NPI:1750836763
Name:SPONAUGLE, SARAH (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:SPONAUGLE
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 1:1208 E KENNEDY BLVD
Mailing Address - Street 2:UNIT 1127
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3504
Mailing Address - Country:US
Mailing Address - Phone:727-366-4219
Mailing Address - Fax:
Practice Address - Street 1:1208 E KENNEDY BLVD
Practice Address - Street 2:UNIT 1127
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3504
Practice Address - Country:US
Practice Address - Phone:727-366-4219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLCH 12050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program