Provider Demographics
NPI:1013020312
Name:GENDILL, ANTHONY ERNEST (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ERNEST
Last Name:GENDILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-1603
Mailing Address - Country:US
Mailing Address - Phone:970-278-1926
Mailing Address - Fax:
Practice Address - Street 1:301 W 50TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-1603
Practice Address - Country:US
Practice Address - Phone:970-278-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor