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NPI Code Detail

MEDICARE: DR. CALEB ANDERSON

MEDICARE:  DR. CALEB  ANDERSON
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
1111N00000XChiropractor2024009439MO

General Provider Information

NPI Number : 1619735859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CALEB ANDERSON
Provider Business Mailing Address
First Line : 7235 GAYOLA PL
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63143-2313
Country : US
Telephone Number : 812-606-5576
Fax Number :
Provider Business Practice Location Address
First Line : 7235 GAYOLA PL
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63143-2313
Country : US
Telephone Number : 812-606-5576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2024
Last Update Date : 03/12/2024

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Directions to “ DR. CALEB ANDERSON ” Practice Location

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