Individual
MR. DAVID EUGENE SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
12214 200TH ST, WADENA, MN 56482-3124
(218) 631-3610
(218) 631-3917
Mailing address
PO BOX 206, WADENA, MN 56482-0206
(218) 631-3610
(218) 631-3917
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302384
MN
Other
Enumeration date
09/19/2017
Last updated
07/21/2022
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