Individual
SONIA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1435 WEST BLVD, RACINE, WI 53405-3428
(262) 417-4191
Mailing address
1435 WEST BLVD, RACINE, WI 53405-3428
(262) 417-4191
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S536-7928-8840-00
WI
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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