Healthcare Provider Details

I. General information

NPI: 1306774203
Provider Name (Legal Business Name): DOCTOR SARA CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 W 63RD PL STE 300
SIOUX FALLS SD
57108-5060
US

IV. Provider business mailing address

2121 W 63RD PL STE 300
SIOUX FALLS SD
57108-5060
US

V. Phone/Fax

Practice location:
  • Phone: 605-323-1166
  • Fax: 605-681-8066
Mailing address:
  • Phone: 605-323-1166
  • Fax: 605-681-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH NIELAND
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 336-818-1552