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Individual

DR. JAY PATRICK ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

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
2301008528
MI
111N00000X
Chiropractor
Primary
3256
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2356445
OH
01
6114246440A00
ANTHEM BLUE CROSS BLUE SH
OH
01
7580510
AETNA
OH
Enumeration date
02/27/2007
Last updated
09/30/2011
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