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General NPI Number Information
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NPI Number | 1609170729
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Entity Type | Organization
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Legal Business Name | COREY ANDERSON DC INC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 223 E 14TH ST SUITE 50
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City | HASTINGS
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State | NE
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Zip | 68901-3200
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Country | US
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Telephone | 402-462-9999
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Fax | 402-462-9545
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Provider Business Mailing Address
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Address Line | 223 E 14TH ST SUITE 50
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City | HASTINGS
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State | NE
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Zip | 68901-3200
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Country | US
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Telephone | 402-462-9999
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Fax | 402-462-9545
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Authorized Official
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Title or Position | OWNER/DOCTOR OF CHIROPRACTIC
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Name | DR. COREY ROBERT ANDERSON
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Credential | D.C,
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Telephone | 402-462-9999
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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 | 1246
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License Number State | NE
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