=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225086952
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAWNDA RAE ANDREWS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2006
-----------------------------------------------------
Last Update Date | 03/27/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 285 SAINT ANDREWS DR SUITE 300
-----------------------------------------------------
City | MANKATO
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56001-8670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-345-1926
-----------------------------------------------------
Fax | 507-345-1750
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 285 SAINT ANDREWS DR SUITE 300
-----------------------------------------------------
City | MANKATO
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56001-8670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-345-1926
-----------------------------------------------------
Fax | 507-345-1750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 4577
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------