Provider Demographics
NPI:1821316878
Name:BETTINGER, SARA (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:BETTINGER
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 1:1907 OLD MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-8957
Mailing Address - Country:US
Mailing Address - Phone:606-759-0090
Mailing Address - Fax:606-759-0092
Practice Address - Street 1:1907 OLD MAIN ST
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-8957
Practice Address - Country:US
Practice Address - Phone:606-759-0090
Practice Address - Fax:606-759-0092
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4066111N00000X
KY5379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100263900Medicaid
OH3075587Medicaid