Individual
MRS. SANDRA MARIE STANTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
500 NORTHLAND DR NE, STE 200, ROCKFORD, MI 49341-7634
(616) 863-9482
(616) 863-9482
Mailing address
PO BOX 803, PINCONNING, MI 48650-0803
(616) 863-9482
(616) 863-9486
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005877
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03995
PRIORITY HEALTH
MI
01
—
P00099912
MEDICARE RAIL ROAD
MI
Enumeration date
12/01/2005
Last updated
07/08/2007
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