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Individual

JEFFREY SANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
405 TALLMADGE RD, STE. 120, CUYAHOGA FALLS, OH 44221-3362
(330) 784-9306
(330) 475-7544
Mailing address
405 TALLMADGE RD, STE. 120, CUYAHOGA FALLS, OH 44221-3362
(330) 784-9306
(330) 475-7544

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35076954S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2333817
OH
01
4072871
MEDICARE ID
OH
01
4072873
MEDICARE ID
OH
Enumeration date
08/31/2005
Last updated
11/28/2011
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