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General NPI Number Information
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NPI Number | 1003456245
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Entity Type | Organization
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Legal Business Name | ANDERSON CHIROPRACTIC HEALTH AND WELLNESS MECCA
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 210 W DAVIS ST STE 100
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City | MESQUITE
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State | TX
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Zip | 75149-4648
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Country | US
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Telephone | 972-807-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 210 W DAVIS ST STE 100
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City | MESQUITE
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State | TX
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Zip | 75149-4648
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Country | US
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Telephone | 972-807-9355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL EDWIN CLAYTON ANDERSON
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Credential | DC
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Telephone | 469-407-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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