Provider Demographics
NPI:1609224138
Name:LANHAM, SAUNDRA
Entity Type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:LANHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 CAP CHAT ST
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-5846
Mailing Address - Country:US
Mailing Address - Phone:706-495-0497
Mailing Address - Fax:
Practice Address - Street 1:4217 CAP CHAT ST
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-5846
Practice Address - Country:US
Practice Address - Phone:706-495-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor