MEDICARE: SARAH DAVIDSON DC

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	35002	CA

General Provider Information

NPI Number	:	1891389714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DAVIDSON DC

Provider Business Mailing Address
First Line	:	4020 RHEA RD
Second Line	:	BUILDING 6D OFFICE 4
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308
Country	:	US
Telephone Number	:	619-495-8478
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 RHEA ROAD
Second Line	:	BUILDING 6D OFFICE 4
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308
Country	:	US
Telephone Number	:	619-495-8478
Fax Number	:

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

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	05/27/2022

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