MEDICARE: DR. GEFF D ANDERSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	C529	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000010007900	OTHER		BS
2	C5295	OTHER		BC

General Provider Information

NPI Number	:	1063590206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEFF D ANDERSON DC

Provider Business Mailing Address
First Line	:	9632 W EMERALD
Second Line	:	STE A
City	:	BOISE
State	:	ID
Zip	:	83704-9762
Country	:	US
Telephone Number	:	208-377-0551
Fax Number	:	208-377-0557

Provider Business Practice Location Address
First Line	:	9632 W EMERALD
Second Line	:	STE A
City	:	BOISE
State	:	ID
Zip	:	83704-9762
Country	:	US
Telephone Number	:	208-377-0551
Fax Number	:	208-377-0557

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. GEFF D ANDERSON DC” Practice Location

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