Provider Demographics
NPI:1245270677
Name:ANDERSSON, EVA MARIE (DC)
Entity type:Individual
Prefix:
First Name:EVA MARIE
Middle Name:
Last Name:ANDERSSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 HAYWOOD RD STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-2607
Mailing Address - Country:US
Mailing Address - Phone:828-696-8900
Mailing Address - Fax:828-595-2721
Practice Address - Street 1:1509 HAYWOOD RD STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2607
Practice Address - Country:US
Practice Address - Phone:828-696-8900
Practice Address - Fax:828-595-2721
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890845XMedicaid
NC890845XMedicaid