MEDICARE: BRIAN ANDERSON LANCASTER 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	0104555598	VA

General Provider Information

NPI Number	:	1477652220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN ANDERSON LANCASTER D.C.

Provider Business Mailing Address
First Line	:	18901 FOUNTAIN HILLS DR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-1872
Country	:	US
Telephone Number	:	301-972-9350
Fax Number	:

Provider Business Practice Location Address
First Line	:	18901 FOUNTAIN HILLS DR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-1872
Country	:	US
Telephone Number	:	301-972-9350
Fax Number	:

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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