Provider Demographics
NPI:1578892303
Name:ANDERSON, DANIEL ERNEST (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ERNEST
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 1:4903 PUMICE LOOP
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6158
Mailing Address - Country:US
Mailing Address - Phone:701-720-8903
Mailing Address - Fax:701-221-2637
Practice Address - Street 1:3138 N 10TH ST # 3A
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0509
Practice Address - Country:US
Practice Address - Phone:701-751-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor