Provider Demographics
NPI:1437250719
Name:SANDO, JOHN J (DC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:SANDO
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 1:22 WEST FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2802
Mailing Address - Country:US
Mailing Address - Phone:406-782-0420
Mailing Address - Fax:406-782-3276
Practice Address - Street 1:22 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2802
Practice Address - Country:US
Practice Address - Phone:406-782-0420
Practice Address - Fax:406-782-3276
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000004585Medicare Oscar/Certification
MTT89329Medicare UPIN