Organization
SANDER CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY A SANDER D.C. (OWNER)
(712) 362-4139
Entity
Organization
Contact information
Practice address
15 S 9TH ST, ESTHERVILLE, IA 51334-2220
(712) 362-4139
Mailing address
15 S 9TH ST, ESTHERVILLE, IA 51334-2220
(712) 362-4139
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A05143
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243089
—
IA
01
—
24308
MEDICARE ID-TYPE UNSPECIFIED
IA
Enumeration date
12/19/2011
Last updated
12/19/2011
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