Provider Demographics
NPI:1669614541
Name:DE PRETER, SARAH JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEAN
Last Name:DE PRETER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:WORSFOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 326
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04614
Mailing Address - Country:US
Mailing Address - Phone:207-374-2186
Mailing Address - Fax:
Practice Address - Street 1:20 E. BLUE HILL ROAD
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614
Practice Address - Country:US
Practice Address - Phone:207-374-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor