MEDICARE: SAPP FAMILY CHIROPRACTIC, LLC

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	4455	OH

General Provider Information

NPI Number	:	1356714455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAPP FAMILY CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	14661 MOCK RD
Second Line	:
City	:	BERLIN CENTER
State	:	OH
Zip	:	44401-8746
Country	:	US
Telephone Number	:	614-296-8102
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 PARK DR
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-1850
Country	:	US
Telephone Number	:	330-426-9453
Fax Number	:	330-426-6815

Authorized Official
Title or Position	:	CHIROPRACTIC PHYSICIAN
Name	:	DR. KRISTA B SAPP
Credential	:	DC, MPH
Telephone Number	:	614-296-8102

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	11/11/2015

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