Healthcare Provider Details

I. General information

NPI: 1982929337
Provider Name (Legal Business Name): SARA YOUNG, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W SAVIDGE ST STE E
SPRING LAKE MI
49456-3108
US

IV. Provider business mailing address

510 W SAVIDGE ST STE E
SPRING LAKE MI
49456-3108
US

V. Phone/Fax

Practice location:
  • Phone: 616-850-0588
  • Fax: 616-850-0590
Mailing address:
  • Phone: 616-850-0588
  • Fax: 616-850-0590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSY009503
License Number StateMI

VIII. Authorized Official

Name: SARA YOUNG
Title or Position: OWNER
Credential: DC
Phone: 616-850-0588