Provider Demographics
NPI:1497084297
Name:SANDLER, JARED SALVATORE (ATC)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:SALVATORE
Last Name:SANDLER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1 COLLEGE STREET
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582
Mailing Address - Country:US
Mailing Address - Phone:706-379-5191
Mailing Address - Fax:706-379-4593
Practice Address - Street 1:4225 UNIVERSITY AVE
Practice Address - Street 2:ATTN: ATHLETICS
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5679
Practice Address - Country:US
Practice Address - Phone:706-565-4332
Practice Address - Fax:706-569-3435
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAT0013272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer