Provider Demographics
NPI:1649506528
Name:ANDERSON, ERIN MARIE (DC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:ANDERSON
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 1:1342 VIRIDIAN PARK LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1186
Mailing Address - Country:US
Mailing Address - Phone:612-280-6596
Mailing Address - Fax:
Practice Address - Street 1:1342 VIRIDIAN PARK LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005-1186
Practice Address - Country:US
Practice Address - Phone:612-280-6596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14802111NP0017X
MN4902111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor