Provider Demographics
NPI:1235827668
Name:EBY, ALEXANDER PAUL (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:PAUL
Last Name:EBY
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 1:888 OLD SHEPARD RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2863
Mailing Address - Country:US
Mailing Address - Phone:435-554-5336
Mailing Address - Fax:
Practice Address - Street 1:5276 S 4425 W
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:UT
Practice Address - Zip Code:84315-6778
Practice Address - Country:US
Practice Address - Phone:435-554-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13375714-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor