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General NPI Number Information
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NPI Number | 1649545229
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE AND INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 201 MEDICAL VILLAGE DR
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City | EDGEWOOD
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State | KY
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Zip | 41017-3407
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Country | US
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Telephone | 859-341-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 601 WASHINGTON AVE STE 390
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City | NEWPORT
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State | KY
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Zip | 41071-1988
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CRAIG D. SANDERS
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Credential | DO
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Telephone | 859-341-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | KY
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