Provider Demographics
NPI:1609979210
Name:ANDERS CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:ANDERS CHIROPRACTIC INC.
Other - Org Name:JOHN P ANDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-326-7401
Mailing Address - Street 1:1315 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-4700
Mailing Address - Country:US
Mailing Address - Phone:620-326-7401
Mailing Address - Fax:620-399-8347
Practice Address - Street 1:1315 W 8TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-4700
Practice Address - Country:US
Practice Address - Phone:620-326-7401
Practice Address - Fax:620-399-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104039111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSDO5570OtherRR MEDICARE PTAN
KSKA1344OtherMEDICARE PTAN