Provider Demographics
NPI:1548834880
Name:PUENTE, SARAH ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PUENTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:UPTMOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1226 E BETHANY HOME RD APT 51A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2035
Mailing Address - Country:US
Mailing Address - Phone:573-837-2560
Mailing Address - Fax:
Practice Address - Street 1:3241 E SHEA BLVD STE 7
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3335
Practice Address - Country:US
Practice Address - Phone:573-837-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty