Anderson Chiropractic | |
3618 Canyon Lake Drive Suite 114 Rapid City SD 57702-3129 | |
(605) 342-7110 | |
Not Available |
Full Name | Anderson Chiropractic |
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Speciality | Clinic/Center |
Location | 3618 Canyon Lake Drive, Rapid City, South Dakota |
Authorized Official Name and Position | Kendall Duane Anderson (PRESIDENT) |
Authorized Official Contact | 6053427110 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Anderson Chiropractic 3618 Canyon Lake Drive Suite 114 Rapid City SD 57702-3129 Ph: (605) 342-7110 | Anderson Chiropractic 3618 Canyon Lake Drive Suite 114 Rapid City SD 57702-3129 Ph: (605) 342-7110 |
NPI Number | 1497920193 |
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Provider Enumeration Date | 04/24/2008 |
Last Update Date | 04/24/2008 |
Medicare PECOS PAC ID | 6608945183 |
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Medicare Enrollment ID | O20080523000445 |
Identifier | Type | State | Issuer |
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1497920193 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 695 (South Dakota) | Primary |
Provider Name | Kendall D Anderson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1700914355 PECOS PAC ID: 3476638206 Enrollment ID: I20080304000571 |
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