Provider Demographics
NPI:1700773637
Name:SANDERS, JENNIFER ALLISON
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ALLISON
Last Name:SANDERS
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 1:600 SYRACUSE RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-8396
Mailing Address - Country:US
Mailing Address - Phone:864-230-1936
Mailing Address - Fax:
Practice Address - Street 1:600 SYRACUSE RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-8396
Practice Address - Country:US
Practice Address - Phone:864-230-1936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist