| Doctor Name: | MRS. SALLY JO SANFORD |
| NPI Number: | 1720103047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN072580 |
| Business Practice Address: | 14 Legacy Way Ste B Adairsville, GA - 301032455 |
| Business Phone Number: | 7707739902 |
| Business Fax Number: | 7707739803 |
| Mailing Address: | 276 Little Rd Ne, RESACA |
| State: | GA |
| Postal Code: | 307356522 |
| Phone Number: | 7066257376 |
| Fax Number: | 7707739803 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN072580 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |