Provider Demographics
NPI:1821550930
Name:LAROSA, SARAH (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:LAROSA
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 1:176 BROOKMEADOW DR SW APT 2
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2197
Mailing Address - Country:US
Mailing Address - Phone:616-278-7453
Mailing Address - Fax:
Practice Address - Street 1:176 BROOKMEADOW DR SW APT 2
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2197
Practice Address - Country:US
Practice Address - Phone:616-278-7453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor