Provider Demographics
NPI:1922543206
Name:PETERSON, SARAH M (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:PETERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:JANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1692
Mailing Address - Country:US
Mailing Address - Phone:402-375-3450
Mailing Address - Fax:402-375-3450
Practice Address - Street 1:1302 W 7TH ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1692
Practice Address - Country:US
Practice Address - Phone:402-375-3450
Practice Address - Fax:402-375-3450
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor