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General NPI Number Information
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NPI Number | 1871689091
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Entity Type | Organization
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Legal Business Name | ANDERSON CHIROPRACTIC INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 903 N BEELINE HWY STE B
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City | PAYSON
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State | AZ
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Zip | 85541-3789
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Country | US
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Telephone | 928-474-7070
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Fax | 928-474-9450
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Provider Business Mailing Address
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Address Line | PO BOX 1318
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City | PAYSON
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State | AZ
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Zip | 85547-1318
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Country | US
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Telephone | 928-474-7070
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Fax | 928-474-9450
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | RODNEY DALE ANDERSON
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Credential | DC
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Telephone | 928-474-7070
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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 | 3751
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License Number State | AZ
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