Provider Demographics
NPI:1023151347
Name:ANDERSON, CURTISS ROGER (DC)
Entity type:Individual
Prefix:DR
First Name:CURTISS
Middle Name:ROGER
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:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-0882
Mailing Address - Country:US
Mailing Address - Phone:907-745-3245
Mailing Address - Fax:
Practice Address - Street 1:939 S DIMOND ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-0882
Practice Address - Country:US
Practice Address - Phone:907-745-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK68111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH00881Medicaid
AKCH00881Medicaid