Individual
JOHN JAMES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
215 N BLACK RIVER ST, SPARTA, WI 54656-1529
(608) 269-4511
(608) 269-8511
Mailing address
415 W WISCONSIN ST, STE 4, SPARTA, WI 54656-2492
(608) 269-4511
(609) 269-8511
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3614-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350052230
RAILROAD MEDICARE
WI
05
—
38923500
—
WI
01
—
38993500
MEDICAID CLINIC NUMBER
WI
01
—
CB3715
RAILROAD MEDICARE GROUP
WI
Enumeration date
05/19/2006
Last updated
05/19/2015
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