# ANDERSON FAMILY CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922290220
- **Authorized official:** DR. JAY PATRICK ANDERSON D.C. (DOCTOR/OWNER)
- **Authorized official phone:** (419) 878-8312

## Contact information

- **Practice address:** 751 MICHIGAN AVE, WATERVILLE, OH 43566-1052
- **Practice address phone:** (419) 878-8312
- **Practice address fax:** (419) 878-8844
- **Mailing address:** PO BOX 254, WATERVILLE, OH 43566-0254
- **Mailing address phone:** (419) 878-8312
- **Mailing address fax:** (419) 878-8844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3256 | OH | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 10/10/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2356445 | — | OH |
| 01 | — | 27882870800 | WORKMAN'S COMPANSATION | OH |
| 01 | — | 27882870801 | MEDICAL MUTUAL OF OHIO | OH |
| 01 | — | 7580510 | AETNA | OH |
| 01 | — | U91632 | UPIN | OH |