Provider Demographics
NPI:1609161769
Name:SADIE SANDERS CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SADIE SANDERS CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SADIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-871-4723
Mailing Address - Street 1:6511 NOVA DR
Mailing Address - Street 2:#235
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7401
Mailing Address - Country:US
Mailing Address - Phone:217-871-4723
Mailing Address - Fax:
Practice Address - Street 1:6511 NOVA DR
Practice Address - Street 2:#235
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33317-7401
Practice Address - Country:US
Practice Address - Phone:217-871-4723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty