Individual
DR. AMY SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
102 INTERCOM DRIVE, MADISON, AL 35758-2638
(256) 772-2929
(256) 772-2928
Mailing address
102 INTERCOM DRIVE, MADISON, AL 35758-2638
(256) 772-2929
(256) 772-2928
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-997-TA-564
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102G700010
PTAN FOR ADVANCED EYECARE OF MADISON
—
Enumeration date
06/15/2005
Last updated
05/07/2012
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