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Individual

MR. JOHN CLANCY SANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
204 PATRICK AVE, URBANA, OH 43078-2302
(937) 653-3445
Mailing address
204 PATRICK AVE, URBANA, OH 43078-2302
(937) 653-3445
(937) 484-6181

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
11/16/2020
Last updated
01/14/2021
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