Individual
TIMOTHY J SANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 S NICOLET RD, APPLETON, WI 54914-8273
(414) 288-5688
Mailing address
701 S NICOLET RD, APPLETON, WI 54914-8273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5468-23
WI
Other
Enumeration date
02/25/2021
Last updated
07/06/2021
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