Provider Demographics
NPI:1972601136
Name:WOLVERTON, SARAH MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARGARET
Last Name:WOLVERTON
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 1:1416 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5038
Mailing Address - Country:US
Mailing Address - Phone:208-906-1485
Mailing Address - Fax:208-906-1489
Practice Address - Street 1:1416 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5038
Practice Address - Country:US
Practice Address - Phone:208-906-1485
Practice Address - Fax:208-906-1489
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor