Organization
JIMMY G. ANDERSON, D.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY G ANDERSON D.C. (OWNER/PRESIDENT)
(651) 777-9757
Entity
Organization
Contact information
Practice address
3394 LAKE ELMO AVENUE, LAKE ELMO, MN 55042-0831
(651) 777-9757
(651) 777-9757
Mailing address
BOX 831, 3394 LAKE ELMO AVENUE NORTH, LAKE ELMO, MN 55042-0831
(651) 777-9757
(651) 777-9757
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1217
MN
111N00000X
Chiropractor
3048
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20135AN
BCBS
MN
05
—
766225400
—
MN
01
—
ON362AN
BCBS
MN
Enumeration date
06/30/2005
Last updated
02/06/2013
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