Individual
JOE ALVIN SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
601 BLUEBIRD BLVD, FORT VALLEY, GA 31030-5082
(478) 825-8691
(478) 825-4458
Mailing address
4581 THIRD DISTRICT RD, UNADILLA, GA 31091-4139
(229) 645-3495
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN113320
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000784979D
—
GA
Enumeration date
03/08/2007
Last updated
07/08/2007
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