Provider Demographics
NPI:1821412164
Name:ANDERSON CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ANDERSON CHIROPRACTIC, LLC
Other - Org Name:HEALTHSOURCE OF ANDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-268-9040
Mailing Address - Street 1:4120 CLEMSON BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1176
Mailing Address - Country:US
Mailing Address - Phone:864-226-0124
Mailing Address - Fax:864-231-9227
Practice Address - Street 1:4120 CLEMSON BLVD.
Practice Address - Street 2:SUITE D
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-226-0124
Practice Address - Fax:864-231-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty