Provider Demographics
NPI:1336267459
Name:SLOAN, SARA S (DC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:S
Last Name:SLOAN
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 1:4785 E 91ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2839
Mailing Address - Country:US
Mailing Address - Phone:918-488-8600
Mailing Address - Fax:
Practice Address - Street 1:4785 E 91ST ST STE B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2839
Practice Address - Country:US
Practice Address - Phone:918-488-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK441111N00000X
TX10351111N00000X
OK3923111N00000X
VA0104556657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5833Medicare PIN