Provider Demographics
NPI:1821381104
Name:SUTTLES, SARA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:LYNN
Last Name:SUTTLES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:LASSITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:189 MILLS LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-5706
Mailing Address - Country:US
Mailing Address - Phone:803-802-0615
Mailing Address - Fax:
Practice Address - Street 1:189 MILLS LN
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-5706
Practice Address - Country:US
Practice Address - Phone:803-802-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1628152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist