Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2646 | CO |
NPI | 1013020312 |
---|---|
Provider Name | Dr. Anthony Ernest Gendill |
First Address | Loveland, CO 80538-1603 |
Second Address | Loveland, CO 80538-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |