Provider Demographics
NPI:1134712607
Name:TORF-FULTON, SARA ELIZABETH (LAC, DAOM)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:TORF-FULTON
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61196 LODGEPOLE DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2880
Mailing Address - Country:US
Mailing Address - Phone:805-258-2684
Mailing Address - Fax:
Practice Address - Street 1:61196 LODGEPOLE DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2880
Practice Address - Country:US
Practice Address - Phone:805-258-2684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC203139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist