Provider Demographics
NPI:1841737301
Name:BURTON, SARA R (DC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:BURTON
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 1:622 S RANGELINE RD
Mailing Address - Street 2:STE. R
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2148
Mailing Address - Country:US
Mailing Address - Phone:317-575-1115
Mailing Address - Fax:317-663-0828
Practice Address - Street 1:622 S RANGELINE RD
Practice Address - Street 2:STE. R
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2148
Practice Address - Country:US
Practice Address - Phone:317-575-1115
Practice Address - Fax:317-663-0828
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002951A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor