MEDICARE: DR. DANIEL ERNEST ANDERSON D.C.

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	849	ND

General Provider Information

NPI Number	:	1578892303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ERNEST ANDERSON D.C.

Provider Business Mailing Address
First Line	:	4903 PUMICE LOOP
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-6158
Country	:	US
Telephone Number	:	701-720-8903
Fax Number	:	701-221-2637

Provider Business Practice Location Address
First Line	:	3138 N 10TH ST # 3A
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-0509
Country	:	US
Telephone Number	:	701-751-7071
Fax Number	:

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

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	12/05/2018

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