Provider Demographics
NPI:1992889547
Name:THYR, SARA (ND)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:THYR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 ACADIA DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-6684
Mailing Address - Country:US
Mailing Address - Phone:707-781-7108
Mailing Address - Fax:707-781-7108
Practice Address - Street 1:405 D ST
Practice Address - Street 2:SUITE1
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3006
Practice Address - Country:US
Practice Address - Phone:707-780-6033
Practice Address - Fax:707-283-0064
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25208D00000X
CAND-316175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice