Healthcare Provider Details

I. General information

NPI: 1538138136
Provider Name (Legal Business Name): CRAIG NORMAN ANDERSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 WESTERN AVE STE. 1
BRATTLEBORO VT
05301-3672
US

IV. Provider business mailing address

316 WESTERN AVE STE. 1
BRATTLEBORO VT
05301-3672
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-4641
  • Fax: 802-254-4641
Mailing address:
  • Phone: 802-254-4641
  • Fax: 802-254-4641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number645
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: