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Individual

SCOTT KENNETH ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
217 5TH ST, FENTON, MI 48430-2771
(810) 750-2600
(810) 750-9186
Mailing address
217 5TH ST, FENTON, MI 48430-2771
(810) 569-0236

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005414
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
950B512170
BLUE CROSSBLUE SHIELD
MI
Enumeration date
12/04/2006
Last updated
11/09/2021
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