Individual
DR. KENNETH J SANDKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1025 GRAND LAKE RD, CELINA, OH 45822-1309
(419) 586-3151
(419) 586-1059
Mailing address
PO BOX 377, CELINA, OH 45822-0377
(419) 586-3151
(419) 586-1059
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3308
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000367947
ANTHEM
OH
01
—
141478
COLE MANAGED VISION
OH
01
—
71115
DAVIS VISION
OH
Enumeration date
02/23/2007
Last updated
12/03/2013
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