Individual
DR. MARK JAMES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
216 WEST MAIN ST, HORTONVILLE, WI 54944
(920) 779-4554
(920) 779-0444
Mailing address
PO BOX 100, HORTONVILLE, WI 54944
(920) 779-4554
(920) 779-0444
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3779
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38936900
—
WI
Enumeration date
09/25/2006
Last updated
08/17/2010
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