Provider Demographics
NPI:1457703480
Name:DAWE, SALLY (DC)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:DAWE
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 1:1052 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3228
Mailing Address - Country:US
Mailing Address - Phone:856-625-7503
Mailing Address - Fax:
Practice Address - Street 1:1052 HEARTWOOD DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3228
Practice Address - Country:US
Practice Address - Phone:856-625-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00351300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor