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General NPI Number Information
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NPI Number | 1831185669
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Entity Type | Individual
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Provider Name | ROBERT RAY ANDERSON DC
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 346 2ND ST
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City | REEDSBURG
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State | WI
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Zip | 53959-1611
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Country | US
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Telephone | 608-524-2616
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Fax | 608-524-3697
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Provider Business Mailing Address
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Address Line | 420 VIKING DR
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City | REEDSBURG
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State | WI
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Zip | 53959-1675
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Country | US
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Telephone | 608-524-2616
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Fax | 608-524-3697
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1736
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License Number State | WI
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