Provider Information for 1508981945
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JOHN L ANDERSON CTRS
Sex: Male
NPI: 1508981945
Last Updated: 2007-07-09
Certification Date:
Certification Date:
Details
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NPI | 1508981945 | ||||||||
Enumeration Date | 2007-03-21 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 8745 COUNTY ROAD 9 S ALAMOSA, CO 81101-9610 United States Phone: 719-589-3671 | Fax:719-589-9136 | ||||||||
Primary Practice Address | 8745 COUNTY ROAD 9 S ALAMOSA, CO 81101-9610 United States Phone: 719-589-3671 | Fax:719-589-9136 | ||||||||
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