MEDICARE: SADIE SANDERS CHIROPRACTIC INC

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	CH9845	FL

General Provider Information

NPI Number	:	1609161769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADIE SANDERS CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	6511 NOVA DR
Second Line	:	#235
City	:	DAVIE
State	:	FL
Zip	:	33317-7401
Country	:	US
Telephone Number	:	217-871-4723
Fax Number	:

Provider Business Practice Location Address
First Line	:	6511 NOVA DR
Second Line	:	#235
City	:	DAVIE
State	:	FL
Zip	:	33317-7401
Country	:	US
Telephone Number	:	217-871-4723
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SADIE SANDERS
Credential	:	D.C.
Telephone Number	:	217-871-4723

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/16/2011

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