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Organization

ANDERSON FAMILY CHIROPRACTIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY PATRICK ANDERSON D.C. (DOCTOR/OWNER)
(419) 878-8312
Entity
Organization

Contact information

Practice address
751 MICHIGAN AVE, WATERVILLE, OH 43566-1052
(419) 878-8312
(419) 878-8844
Mailing address
PO BOX 254, WATERVILLE, OH 43566-0254
(419) 878-8312
(419) 878-8844

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3256
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2356445
OH
01
27882870800
WORKMAN'S COMPANSATION
OH
01
27882870801
MEDICAL MUTUAL OF OHIO
OH
01
7580510
AETNA
OH
01
U91632
UPIN
OH
Enumeration date
08/10/2007
Last updated
10/10/2011
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