Healthcare Provider Details

I. General information

NPI: 1972694313
Provider Name (Legal Business Name): DONALD J ANDERSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/09/2007
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 Number006 0000889
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: