Provider Demographics
NPI:1932237104
Name:RODGERS, SARA C (NMD, ND, CAC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:C
Last Name:RODGERS
Suffix:
Gender:F
Credentials:NMD, ND, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-2403
Mailing Address - Country:US
Mailing Address - Phone:208-275-0007
Mailing Address - Fax:208-514-4563
Practice Address - Street 1:903 3RD AVE N
Practice Address - Street 2:
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-2403
Practice Address - Country:US
Practice Address - Phone:208-275-0007
Practice Address - Fax:208-514-4563
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACC-247171100000X
OR3073175F00000X
IDNMD-0018175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist