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General NPI Number Information
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NPI Number | 1609533249
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Entity Type | Organization
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Legal Business Name | ANDERSON CHIROPRACTIC, PC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 4127 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1102
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Country | US
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Telephone | 505-308-8885
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Fax | 505-308-8886
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Provider Business Mailing Address
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Address Line | 4127 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1102
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Country | US
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Telephone | 505-308-8885
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Fax | 505-308-8886
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | TAYLOR ALEXIS BLACKFORD ANDERSON
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Credential | DC
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Telephone | 505-308-8885
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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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