Healthcare Provider Details

I. General information

NPI: 1902447352
Provider Name (Legal Business Name): SARAH FRIEDRICH DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KIOWA DR W
LAKE KIOWA TX
76240-9584
US

IV. Provider business mailing address

3850 HOLCOMB BRIDGE RD STE 105
PEACHTREE CORNERS GA
30092-5220
US

V. Phone/Fax

Practice location:
  • Phone: 940-668-8755
  • Fax:
Mailing address:
  • Phone: 770-696-2401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14236
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: