Provider Demographics
NPI:1972613446
Name:WINDHAM, SARA E (CH)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:WINDHAM
Suffix:
Gender:F
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15 SARAHSETTER TRL
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-8861
Mailing Address - Country:US
Mailing Address - Phone:803-257-1044
Mailing Address - Fax:888-870-8661
Practice Address - Street 1:6110 WOODSIDE EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-3820
Practice Address - Country:US
Practice Address - Phone:803-257-1044
Practice Address - Fax:888-870-8661
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor