Provider Demographics
NPI:1679952204
Name:ANDERSON, ERIN (DC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
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 1:13911 RIDGEDALE DRIVE
Mailing Address - Street 2:SUITE 490
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305
Mailing Address - Country:US
Mailing Address - Phone:612-223-8676
Mailing Address - Fax:612-979-2610
Practice Address - Street 1:13911 RIDGEDALE DRIVE
Practice Address - Street 2:SUITE 490
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:612-223-8676
Practice Address - Fax:612-979-2610
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor