Provider Demographics
NPI:1114284320
Name:SWENSON, ALEXANDRA FREUND (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:FREUND
Last Name:SWENSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:FREUND
Other - Last Name:GERDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:912 BARNETTE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4510
Mailing Address - Country:US
Mailing Address - Phone:907-451-7000
Mailing Address - Fax:907-891-7297
Practice Address - Street 1:912 BARNETTE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4510
Practice Address - Country:US
Practice Address - Phone:907-451-7000
Practice Address - Fax:907-891-7297
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
202G707655Medicare PIN