Provider Demographics
NPI:1972652881
Name:SUSAN J ANDERSON, DC INC
Entity Type:Organization
Organization Name:SUSAN J ANDERSON, DC INC
Other - Org Name:CHIROPRACTIC ASSOCIATES OF EAGLE RIVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-694-8881
Mailing Address - Street 1:16331 HERITAGE PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7714
Mailing Address - Country:US
Mailing Address - Phone:907-694-8881
Mailing Address - Fax:907-694-8892
Practice Address - Street 1:16331 HERITAGE PL
Practice Address - Street 2:SUITE 101
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7714
Practice Address - Country:US
Practice Address - Phone:907-694-8881
Practice Address - Fax:907-694-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA 327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK=========OtherEIN