Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC011113 | PA |
N | 111NR0400X | Rehabilitation Chiropractor | AJ010880 | PA |
NPI | 1265899397 |
---|---|
Provider Name | Dr. Sarah Balthaser |
First Address | Wyomissing, PA 19610-1898 |
Second Address | Wyomissing, PA 19610-1898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2016 |
Last Update Date | 06/04/2018 |