MEDICARE: DR. GREGORY ALAN SANDER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	A05143	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629127048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY ALAN SANDER D.C.

Provider Business Mailing Address
First Line	:	508 W CENTRAL AVE
Second Line	:
City	:	ESTHERVILLE
State	:	IA
Zip	:	51334-1834
Country	:	US
Telephone Number	:	712-362-7715
Fax Number	:	712-362-7716

Provider Business Practice Location Address
First Line	:	508 W CENTRAL AVE
Second Line	:
City	:	ESTHERVILLE
State	:	IA
Zip	:	51334-1834
Country	:	US
Telephone Number	:	712-362-7715
Fax Number	:	712-362-7716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/23/2021

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