Provider Demographics
NPI:1063449304
Name:LABARBERA, ALEXIS JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:JOHN
Last Name:LABARBERA
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 1:301 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1902
Mailing Address - Country:US
Mailing Address - Phone:540-586-1105
Mailing Address - Fax:540-586-1194
Practice Address - Street 1:301 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1902
Practice Address - Country:US
Practice Address - Phone:540-586-1105
Practice Address - Fax:540-586-1194
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
00X551L01Medicare PIN