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DR. MARK JAMES ANDERSON DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1124128509

Individual Registrant:
DR. MARK JAMES ANDERSON DC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
216 WEST MAIN ST  HORTONVILLE, WI 54944 US
Tel: 920-779-4554  Fax: 920-779-0444

Contact information for business:
PO BOX 100  HORTONVILLE, WI 54944 US
Tel: 920-779-4554  Fax: 920-779-0444

Registration Information:
NPI: 1124128509
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
WI3779

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
38936900WI05




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