MEDICARE: THE VILLAGE COLLABORATIVE, LLC

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

General Provider Information

NPI Number	:	1720919848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VILLAGE COLLABORATIVE, LLC

Provider Business Mailing Address
First Line	:	3961 COLUMBIA RD UNIT B
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-2219
Country	:	US
Telephone Number	:	706-432-1141
Fax Number	:

Provider Business Practice Location Address
First Line	:	3961 COLUMBIA RD UNIT B
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-2219
Country	:	US
Telephone Number	:	706-432-1141
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. SANDRA DUNN ANDERSON
Credential	:	DC
Telephone Number	:	706-432-1141

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “THE VILLAGE COLLABORATIVE, LLC ” Practice Location

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