Healthcare Provider Details

I. General information

NPI: 1346892684
Provider Name (Legal Business Name): SARAH RIDER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7839 BROAD RIVER ROAD
IRMO SC
29063-2357
US

IV. Provider business mailing address

7839 BROAD RIVER ROAD
IRMO SC
29063-2357
US

V. Phone/Fax

Practice location:
  • Phone: 803-732-3996
  • Fax: 803-749-4696
Mailing address:
  • Phone: 803-732-3996
  • Fax: 803-749-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010814
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4890
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: