Doctor Name: | CHAD ANDERSON |
NPI Number: | 1902214992 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 5716 |
Business Practice Address: | 411 Mill Beach Rd Ste A Brookings, OR - 974159690 |
Business Phone Number: | 5414692276 |
Business Fax Number: | 5414690489 |
Mailing Address: | Po Box 7967, BROOKINGS |
State: | OR |
Postal Code: | 974150374 |
Phone Number: | 5414692276 |
Fax Number: | 5414690489 |
NPI Enumeration Date: | 07/23/2014 |
NPI Last Update Date: | 05/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 5716 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
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. |