Provider Demographics
NPI:1932338845
Name:ANDERSON, ALISHA LEANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:LEANN
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 1:4132 30TH AVE S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8407
Mailing Address - Country:US
Mailing Address - Phone:701-241-7737
Mailing Address - Fax:701-241-7738
Practice Address - Street 1:4132 30TH AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8407
Practice Address - Country:US
Practice Address - Phone:701-241-7737
Practice Address - Fax:701-241-7738
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor