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General NPI Number Information
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NPI Number | 1649461922
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Entity Type | Organization
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Legal Business Name | MICHAEL J ANDERLA D.C., P.A.
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 4064 LAKELAND AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2236
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Country | US
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Telephone | 763-746-1244
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Fax |
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Provider Business Mailing Address
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Address Line | 4064 LAKELAND AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2236
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Country | US
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Telephone |
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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 ANDERLA
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Credential | D.C.
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Telephone | 763-746-1244
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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 | 4903
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License Number State | MN
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