Individual
RENATA M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
559 BRAUND ST, STE 3, ONALASKA, WI 54650-8658
(608) 783-7735
(608) 783-7762
Mailing address
415 W WISCONSIN ST, STE 4, SPARTA, WI 54656-2492
(608) 269-4511
(608) 269-8511
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3615-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350050305
RAILROAD MEDICARE
WI
05
—
38924400
—
WI
01
—
CB3715
RAILROAD MEDICARE GROUP
—
Enumeration date
09/15/2006
Last updated
05/19/2015
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