Doctor Name: | DR. SCOTT RAVN ANDERSEN |
NPI Number: | 1013095348 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | A05758 |
Business Practice Address: | 1910 Washington St Suite 100 Pella, IA - 502190062 |
Business Phone Number: | 6416211910 |
Business Fax Number: | |
Mailing Address: | 1910 Washington St, Po Box 62 PELLA |
State: | IA |
Postal Code: | 502197882 |
Phone Number: | 6416211910 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 12/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | A05758 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |