Individual
CHARLES MARTIN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
255 W STEWART AVE, STE101, MEDFORD, OR 97501-3600
(541) 779-9650
(541) 779-5315
Mailing address
255 W STEWART AVE, STE101, MEDFORD, OR 97501-3600
(541) 779-9650
(541) 779-5315
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2453
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085306000
BC/BS
OR
Enumeration date
05/05/2006
Last updated
01/23/2008
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