Individual
JORDAN SANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1457 KING FISHER RD, HIAWATHA, KS 66434-8530
(785) 691-5684
Mailing address
1457 KING FISHER RD, HIAWATHA, KS 66434-8530
(785) 691-5684
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15151
CA
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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