MEDICARE: JERI L ANDERSON PROF CHIROPRACTIC CORP

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	DC18303	CA

General Provider Information

NPI Number	:	1891970109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JERI L ANDERSON PROF CHIROPRACTIC CORP

Provider Business Mailing Address
First Line	:	9500 MICRON AVE
Second Line	:	SUITE 108
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:	916-368-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 MICRON AVE
Second Line	:	SUITE 108
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:	916-368-1600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JERI ANDERSON
Credential	:	D.C.
Telephone Number	:	916-368-1600

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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