Individual
SARA VIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 S BRENTWOOD BLVD, BRENTWOOD, MO 63144
(314) 678-9355
Mailing address
2300 S BRENTWOOD BLVD, BRENTWOOD, MO 63144-2026
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2004030636
MO
Other
Enumeration date
06/23/2006
Last updated
08/09/2018
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