Individual
JACOB SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
85 E US HIGHWAY 6, VALPARAISO, IN 46383-8947
(219) 983-8300
Mailing address
3668 GATEMAN ST, PORTAGE, IN 46368-5429
(219) 730-1209
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2458886
MN
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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