Provider Demographics
NPI:1013292044
Name:DSANDERLLC
Entity Type:Organization
Organization Name:DSANDERLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-594-8947
Mailing Address - Street 1:9635 W CHATFIELD AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9202
Mailing Address - Country:US
Mailing Address - Phone:303-594-8947
Mailing Address - Fax:
Practice Address - Street 1:9635 W CHATFIELD AVE UNIT B
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-9202
Practice Address - Country:US
Practice Address - Phone:303-594-8947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty