Provider Demographics
NPI:1447300538
Name:ANDERSON CHIROPRACTIC OF OSHKOSH, S. C.
Entity type:Organization
Organization Name:ANDERSON CHIROPRACTIC OF OSHKOSH, S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-235-7373
Mailing Address - Street 1:420 S KOELLER ST
Mailing Address - Street 2:SUITE 345
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-5560
Mailing Address - Country:US
Mailing Address - Phone:920-235-7373
Mailing Address - Fax:920-235-7713
Practice Address - Street 1:420 S KOELLER ST
Practice Address - Street 2:SUITE 345
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-5560
Practice Address - Country:US
Practice Address - Phone:920-235-7373
Practice Address - Fax:920-235-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty