Provider Demographics
NPI:1427763986
Name:RADZVILLE, ALEXANDRA CAMERON (DC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:CAMERON
Last Name:RADZVILLE
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 1:5670 SAN ANTONIO DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-7279
Mailing Address - Country:US
Mailing Address - Phone:517-375-5326
Mailing Address - Fax:
Practice Address - Street 1:116 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1425
Practice Address - Country:US
Practice Address - Phone:515-967-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor