Provider Demographics
NPI:1033354246
Name:ANDERSON, CHAD NICKOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:NICKOLAS
Last Name:ANDERSON
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:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-0848
Mailing Address - Country:US
Mailing Address - Phone:919-552-0751
Mailing Address - Fax:919-552-0891
Practice Address - Street 1:131 W HOLLY SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7083
Practice Address - Country:US
Practice Address - Phone:919-552-0751
Practice Address - Fax:919-552-0891
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3906111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor