Provider Demographics
NPI:1891716205
Name:ANDERSON, KARL ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:ERIC
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 1:1411 W SAINT GERMAIN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4121
Mailing Address - Country:US
Mailing Address - Phone:320-656-5441
Mailing Address - Fax:320-656-5441
Practice Address - Street 1:1411 W SAINT GERMAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4121
Practice Address - Country:US
Practice Address - Phone:320-656-5441
Practice Address - Fax:320-656-5441
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor