Healthcare Provider Details

I. General information

NPI: 1790995108
Provider Name (Legal Business Name): DONALD J. ANDERSON D.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 HOLIDAY DR SUITE 22
WHITE RIVER JUNCTION VT
05001-2043
US

IV. Provider business mailing address

222 HOLIDAY DR SUITE 22
WHITE RIVER JUNCTION VT
05001-2043
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-9360
  • Fax: 802-295-9360
Mailing address:
  • Phone: 802-295-9360
  • Fax: 802-295-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number889
License Number StateVT

VIII. Authorized Official

Name: DR. DONALD J ANDERSON
Title or Position: OWNER
Credential: D.C.
Phone: 802-295-9360