Provider Demographics
NPI:1427176122
Name:ANDERSON, DONALD GENE (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GENE
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 E HORSETOOTH RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3189
Mailing Address - Country:US
Mailing Address - Phone:970-225-1006
Mailing Address - Fax:970-225-0020
Practice Address - Street 1:400 E HORSETOOTH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3189
Practice Address - Country:US
Practice Address - Phone:970-225-1006
Practice Address - Fax:970-225-0020
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO111N00000XOtherCHIROPRACTIC