Individual
MR. LANARD DONTE SANDERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5242 SYLVESTER ST, PHILADELPHIA, PA 19124-1816
(267) 582-6571
Mailing address
5242 SYLVESTER ST, PHILADELPHIA, PA 19124-1816
(267) 582-6571
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
29434224
PA
Other
Enumeration date
07/30/2020
Last updated
11/08/2021
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