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Individual

SARA MAHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAC

Contact information

Practice address
1807 WILLIAMS ST, STURGIS, SD 57785-1142
(605) 347-3003
Mailing address
1807 WILLIAMS ST, STURGIS, SD 57785-1142
(605) 347-3003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12091544
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
466036107
SD
Enumeration date
08/02/2016
Last updated
08/02/2016
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