Provider Demographics
NPI:1275685430
Name:SANDERS, JAY DANFORD (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:DANFORD
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 1:7610 W 5TH AVE
Mailing Address - Street 2:#102
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1458
Mailing Address - Country:US
Mailing Address - Phone:303-232-1178
Mailing Address - Fax:303-232-1000
Practice Address - Street 1:7610 W 5TH AVE
Practice Address - Street 2:#102
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1458
Practice Address - Country:US
Practice Address - Phone:303-232-1178
Practice Address - Fax:303-232-1000
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
12243Medicare ID - Type Unspecified
COT60397Medicare UPIN