Provider Demographics
NPI:1144240300
Name:SANDERS, ALVIN BENJAMIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:BENJAMIN
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 S COUNTRY CLUB DR
Mailing Address - Street 2:SUITE 111-B
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-4649
Mailing Address - Country:US
Mailing Address - Phone:480-834-1700
Mailing Address - Fax:480-834-1200
Practice Address - Street 1:1140 S COUNTRY CLUB DR
Practice Address - Street 2:SUITE 111-B
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4649
Practice Address - Country:US
Practice Address - Phone:480-834-1700
Practice Address - Fax:480-834-1200
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor