Provider Demographics
NPI:1841610805
Name:VANCLEAVE, SARAH LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LEE
Last Name:VANCLEAVE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:LEE
Other - Last Name:VANCLEAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4501 COLEMAN ST STE 108A
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0995
Mailing Address - Country:US
Mailing Address - Phone:701-751-2700
Mailing Address - Fax:
Practice Address - Street 1:1921 N 13TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1973
Practice Address - Country:US
Practice Address - Phone:360-927-5123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor