Provider Demographics
NPI:1588944482
Name:DAVID L. SANDERS, D.C., P.C.
Entity type:Organization
Organization Name:DAVID L. SANDERS, D.C., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-425-0034
Mailing Address - Street 1:4350 WADSWORTH BLVD
Mailing Address - Street 2:STE 355
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4641
Mailing Address - Country:US
Mailing Address - Phone:303-425-0034
Mailing Address - Fax:303-425-5378
Practice Address - Street 1:4350 WADSWORTH BLVD
Practice Address - Street 2:STE. 355
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4641
Practice Address - Country:US
Practice Address - Phone:303-425-0034
Practice Address - Fax:303-425-5378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO01656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU03257Medicare UPIN