Provider Demographics
NPI:1710073432
Name:PATRICK C. ANDERSEN, D.C., S.C.
Entity Type:Organization
Organization Name:PATRICK C. ANDERSEN, D.C., S.C.
Other - Org Name:CHIROPRACTICUSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-833-1282
Mailing Address - Street 1:6502 NORMANDY LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1082
Mailing Address - Country:US
Mailing Address - Phone:608-833-1282
Mailing Address - Fax:608-833-5727
Practice Address - Street 1:6502 NORMANDY LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1082
Practice Address - Country:US
Practice Address - Phone:608-833-1282
Practice Address - Fax:608-833-5727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty