Provider Demographics
NPI:1063545770
Name:MABRA, SARAH MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:MABRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 17TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2447
Mailing Address - Country:US
Mailing Address - Phone:580-254-5145
Mailing Address - Fax:580-254-5144
Practice Address - Street 1:911 17TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2447
Practice Address - Country:US
Practice Address - Phone:580-254-5145
Practice Address - Fax:580-254-5144
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor