Amanda Nicole Anderson, DC
Individual provider Active NPI Chiropractor · Wayzata, MN
NPI 1265997258 · NPPES record last updated Feb 5, 2019
Key facts
- NPI
- 1265997258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6601 (MN)
- Practice address
- 101 Lake St W
Wayzata, MN 55391-1576 - Phone
- (952) 473-1773
- Fax
- (844) 235-6985
- NPI assigned
- Feb 5, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Due North Chiropractic LLC | Current |
Accepting new patients | |
| Reneu Physical Therapy LLC | Current |
Accepting new patients |
Locations
101 Lake St W
Ste 210
Wayzata, MN 55391
Phone (612) 562-6581
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6601 | MN | Yes |
Addresses
Primary practice location
101 Lake St W
Wayzata, MN 55391-1576
Mailing address
3709 46TH Ave S
Minneapolis, MN 55406-2912
Phone (715) 614-0198
Other providers in Wayzata, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.