Provider Demographics
NPI:1619035359
Name:SANSONE, JAMES J (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:SANSONE
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 1:6775 APPLEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4940
Mailing Address - Country:US
Mailing Address - Phone:330-758-2353
Mailing Address - Fax:330-758-9733
Practice Address - Street 1:6775 APPLEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4940
Practice Address - Country:US
Practice Address - Phone:330-758-2353
Practice Address - Fax:330-758-9733
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH414111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician