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General NPI Number Information
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NPI Number | 1770855207
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Entity Type | Organization
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Legal Business Name | KIMBERLY S ANDERSON DC PLC
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 50 FILER ST SUITE 216
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City | MANISTEE
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State | MI
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Zip | 49660-2726
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Country | US
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Telephone | 231-723-2221
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Fax | 231-723-5078
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Provider Business Mailing Address
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Address Line | 50 FILER ST SUITE 216
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City | MANISTEE
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State | MI
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Zip | 49660-2726
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Country | US
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Telephone | 231-723-2221
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Fax | 231-723-5078
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. KIMBERLY S ANDERSON
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Credential | D. C.
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Telephone | 231-723-2221
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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 | 2301009152
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License Number State | MI
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