Provider Demographics
NPI:1598361453
Name:ANDERSON, SAWYER A (DC)
Entity Type:Individual
Prefix:DR
First Name:SAWYER
Middle Name:A
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 1:4429 98TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-1363
Mailing Address - Country:US
Mailing Address - Phone:641-229-5018
Mailing Address - Fax:
Practice Address - Street 1:2925 INGERSOLL AVE STE 2
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-4052
Practice Address - Country:US
Practice Address - Phone:515-255-3021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor