Provider Demographics
NPI:1508964214
Name:ANDERSON, WILLIAM BRADFORD
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRADFORD
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 OXMEAD RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4215
Mailing Address - Country:US
Mailing Address - Phone:609-386-6100
Mailing Address - Fax:609-386-2838
Practice Address - Street 1:1603 OXMEAD RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4215
Practice Address - Country:US
Practice Address - Phone:609-386-6100
Practice Address - Fax:609-386-2838
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00578100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor