Provider Demographics
NPI:1821539453
Name:TREFNOFF, SARA (DC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TREFNOFF
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 1:102 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:PA
Mailing Address - Zip Code:15342-1518
Mailing Address - Country:US
Mailing Address - Phone:724-678-2378
Mailing Address - Fax:412-653-7684
Practice Address - Street 1:1150 WILDLIFE LODGE RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3562
Practice Address - Country:US
Practice Address - Phone:412-655-4362
Practice Address - Fax:412-653-7684
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADC011237OtherLICENSE