Provider Demographics
NPI:1790534873
Name:BASINGER, SARAH (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:BASINGER
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 1:1930 W MILHAM AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-2228
Mailing Address - Country:US
Mailing Address - Phone:269-345-2273
Mailing Address - Fax:
Practice Address - Street 1:1930 W MILHAM AVE STE D
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-2228
Practice Address - Country:US
Practice Address - Phone:269-345-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor