Provider Demographics
NPI:1831343151
Name:NELSON-OSTERHOLZ, SARA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIE
Last Name:NELSON-OSTERHOLZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:664 N HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1852
Mailing Address - Country:US
Mailing Address - Phone:608-234-1234
Mailing Address - Fax:608-829-1760
Practice Address - Street 1:664 N HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1852
Practice Address - Country:US
Practice Address - Phone:608-234-1234
Practice Address - Fax:608-829-1760
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1540111N00000X
WI4801-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor