Doctor Name: | JOHN W. ANDERSON |
NPI Number: | 1346552676 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 489DLC-386310 |
Business Practice Address: | 112 Center Ave S Mitchellville, IA - 501699765 |
Business Phone Number: | 5159671670 |
Business Fax Number: | 5159671670 |
Mailing Address: | 112 Center Ave S, MITCHELLVILLE |
State: | IA |
Postal Code: | 501699765 |
Phone Number: | 5159671670 |
Fax Number: | 5159671670 |
NPI Enumeration Date: | 07/01/2010 |
NPI Last Update Date: | 07/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 489DLC-386310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |