Individual
DR. SARA JEAN CUPERUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2380 TROOP DRIVE, SUITE 201, SARTELL, MN 56377-4637
(320) 255-0961
(320) 258-4001
Mailing address
2380 TROOP DRIVE, SUITE 201, SARTELL, MN 56377-4637
(320) 255-0961
(320) 258-4001
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
4331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331J2CH
BCBS CLINIC PROVIDER #
MN
01
—
332J9KL
BCBS INDIVIDUAL #
MN
01
—
350056798
RAILROAD MEDICARE
MN
01
—
777641100
MN HEALTH CARE PROGRAMS
MN
01
—
C03940
MEDICARE CLINIC ID
MN
Enumeration date
06/27/2005
Last updated
01/04/2017
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