Individual
JOHN R SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12289 LEAVITT RD, UNIT D, OBERLIN, OH 44074-8500
(440) 775-1555
(440) 775-1556
Mailing address
12289 LEAVITT RD, UNIT D, OBERLIN, OH 44074-8500
(440) 775-1555
(440) 775-1556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34006510
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2131213
—
OH
Enumeration date
10/10/2006
Last updated
04/02/2008
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