Provider Demographics
NPI:1760543847
Name:SANDERS CHIROPRACTIC
Entity Type:Organization
Organization Name:SANDERS CHIROPRACTIC
Other - Org Name:WAUNETTE PUHL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-793-2096
Mailing Address - Street 1:1001 TATE DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-4334
Mailing Address - Country:US
Mailing Address - Phone:334-793-2096
Mailing Address - Fax:334-793-7559
Practice Address - Street 1:1001 TATE DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-4334
Practice Address - Country:US
Practice Address - Phone:334-793-2096
Practice Address - Fax:334-793-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALA0020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty