Provider Demographics
NPI:1851005151
Name:KEBRDLE, ALEC (DC)
Entity type:Individual
Prefix:DR
First Name:ALEC
Middle Name:
Last Name:KEBRDLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 N CAPITOL AVE STE A-265
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1044
Mailing Address - Country:US
Mailing Address - Phone:317-967-0440
Mailing Address - Fax:
Practice Address - Street 1:1060 N CAPITOL AVE STE A265
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1044
Practice Address - Country:US
Practice Address - Phone:317-967-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14352111N00000X
IN08003480A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor