Provider Demographics
NPI:1972744647
Name:ALEXANDER CHIROPRACTIC PA
Entity type:Organization
Organization Name:ALEXANDER CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-286-8868
Mailing Address - Street 1:1500 N HARPER ROAD EXT
Mailing Address - Street 2:STE. 2
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-3700
Mailing Address - Country:US
Mailing Address - Phone:662-286-8868
Mailing Address - Fax:662-286-8868
Practice Address - Street 1:1500 N HARPER ROAD EXT
Practice Address - Street 2:STE. 2
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-3700
Practice Address - Country:US
Practice Address - Phone:662-286-8868
Practice Address - Fax:662-286-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty