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General NPI Number Information
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NPI Number | 1700985728
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Entity Type | Organization
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Legal Business Name | ANDERSON CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 385 AIRPORT RD
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City | BEAVER
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State | WV
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Zip | 25813-9596
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Country | US
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Telephone | 304-256-1110
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Fax | 304-256-2442
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Provider Business Mailing Address
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Address Line | 385 AIRPORT RD
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City | BEAVER
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State | WV
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Zip | 25813-9596
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Country | US
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Telephone | 304-256-1110
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Fax | 304-256-2442
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALISHA D ANDERSON
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Credential | DC
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Telephone | 304-256-1110
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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 | 761
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License Number State | WV
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