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General NPI Number Information
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NPI Number | 1780888438
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Entity Type | Organization
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Legal Business Name | ALTOONA FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 2204 N HILLCREST PKWY STE 1
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City | ALTOONA
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State | WI
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Zip | 54720-2627
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Country | US
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Telephone | 715-834-8288
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Fax |
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Provider Business Mailing Address
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Address Line | 2204 N HILLCREST PKWY STE 1
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City | ALTOONA
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State | WI
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Zip | 54720-2627
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Country | US
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Telephone | 715-834-8288
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Fax |
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Authorized Official
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Title or Position | CEO DOCTOR
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Name | DR. KYLE DANIEL ANDERSON
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Credential |
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Telephone | 715-834-8828
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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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