Provider Demographics
NPI:1316027824
Name:ANDERSON, THOMAS W (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4568 HIGHLAND DR STE 340
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4233
Mailing Address - Country:US
Mailing Address - Phone:801-272-9989
Mailing Address - Fax:801-272-1482
Practice Address - Street 1:4568 HIGHLAND DR STE 340
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4233
Practice Address - Country:US
Practice Address - Phone:801-272-9989
Practice Address - Fax:801-272-1482
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171739-1202111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health