Provider Demographics
NPI:1821142316
Name:SANDS., SUSAN F (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:F
Last Name:SANDS.
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0920
Mailing Address - Country:US
Mailing Address - Phone:352-732-2745
Mailing Address - Fax:352-732-8066
Practice Address - Street 1:1007 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0920
Practice Address - Country:US
Practice Address - Phone:352-732-2745
Practice Address - Fax:352-732-8066
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55899AMedicare PIN