Provider Demographics
NPI:1184892127
Name:ANDERSON, MARGARET CLAIRE (LMT, MLD/CDT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:CLAIRE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMT, MLD/CDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:PLUM
Mailing Address - State:TX
Mailing Address - Zip Code:78952-0085
Mailing Address - Country:US
Mailing Address - Phone:979-242-3382
Mailing Address - Fax:
Practice Address - Street 1:300 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-5133
Practice Address - Country:US
Practice Address - Phone:979-242-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21226172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist