MEDICARE: DR. SARA ELISABETH TRIPPS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08002541A	IN

General Provider Information

NPI Number	:	1114942141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA ELISABETH TRIPPS D.C.

Provider Business Mailing Address
First Line	:	539 E WASHINGTON ST
Second Line	:
City	:	SULLIVAN
State	:	IN
Zip	:	47882-1624
Country	:	US
Telephone Number	:	812-699-9791
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 W WASHINGTON ST
Second Line	:
City	:	SULLIVAN
State	:	IN
Zip	:	47882-1524
Country	:	US
Telephone Number	:	812-699-9791
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/30/2020

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