Healthcare Provider Details

I. General information

NPI: 1740234509
Provider Name (Legal Business Name): JOHN JAMES ANDERSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 BRAUND ST STE 3
ONALASKA WI
54650-8659
US

IV. Provider business mailing address

415 W WISCONSIN ST STE 4
SPARTA WI
54656-2493
US

V. Phone/Fax

Practice location:
  • Phone: 608-783-7735
  • Fax:
Mailing address:
  • Phone: 608-269-4511
  • Fax: 609-269-8511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3614-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: