Provider Demographics
NPI:1063575546
Name:ANDEN CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:ANDEN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-930-8060
Mailing Address - Street 1:193 FINLEY RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-3822
Mailing Address - Country:US
Mailing Address - Phone:724-930-8060
Mailing Address - Fax:724-930-8083
Practice Address - Street 1:193 FINLEY RD
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-3822
Practice Address - Country:US
Practice Address - Phone:724-930-8060
Practice Address - Fax:724-930-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC0006158L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA995549OtherHIGHMARK
PA2693544OtherAETNA HMO
PA7902317OtherAETNA PPO
PA894308OtherBLUE CROSS BLUE SHIELD
PA1041004OtherGATEWAY HEALTH PLAN
AL81942OtherUNISON HEALTH PLAN
PA11170954OtherCAQH
PA3322040OtherCIGNA
PA0016165810002Medicaid
PA894308OtherBLUE CROSS BLUE SHIELD
PA7902317OtherAETNA PPO