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General NPI Number Information
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NPI Number | 1417768961
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Entity Type | Organization
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Legal Business Name | ANDERSON CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 111 W MAIN ST
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City | FREDERICKSBURG
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State | IA
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Zip | 50630-7705
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Country | US
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Telephone | 563-237-6560
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Fax | 563-237-6562
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | FREDERICKSBURG
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State | IA
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Zip | 50630-0207
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Country | US
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Telephone | 563-237-6560
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Fax | 563-237-6562
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | SAWYER A ANDERSON
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Credential | D.C.
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Telephone | 641-229-5018
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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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