Provider Demographics
NPI:1093035826
Name:ANDERSON, ASHLEY A (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 N MAIN STREET
Mailing Address - Street 2:PO BOX 3
Mailing Address - City:CADOTT
Mailing Address - State:WI
Mailing Address - Zip Code:54727-9658
Mailing Address - Country:US
Mailing Address - Phone:715-978-0600
Mailing Address - Fax:715-978-0601
Practice Address - Street 1:2029 COUNTY HIGHWAY I STE 3
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-4420
Practice Address - Country:US
Practice Address - Phone:715-720-8500
Practice Address - Fax:715-720-8507
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5384111N00000X
WI4987-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350004637Medicare UPIN