Individual
TEAL SANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
98 CHICAGO ST, GORHAM, KS 67640-9047
(785) 650-8712
(785) 302-9547
Mailing address
PO BOX 128, GORHAM, KS 67640-0128
(785) 650-8712
(785) 302-9547
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01926
KS
Other
Enumeration date
09/14/2016
Last updated
10/25/2022
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