Provider Demographics
NPI:1962401661
Name:SANDS, TODD MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:SANDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 SUPERIOR DR NW
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1988
Mailing Address - Country:US
Mailing Address - Phone:507-287-6041
Mailing Address - Fax:507-287-6438
Practice Address - Street 1:2518 SUPERIOR DR NW
Practice Address - Street 2:SUITE 101B
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1988
Practice Address - Country:US
Practice Address - Phone:507-287-6041
Practice Address - Fax:507-287-6438
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3017111N00000X
IAA5626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4C491SAOtherBLUE CROSS BLUE SHIELD
MN977028300Medicaid
MN4C491SAOtherBLUE CROSS BLUE SHIELD
MN977028300Medicaid