Provider Demographics
NPI:1255507182
Name:ISAENKO, ALEXSANDR A (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXSANDR
Middle Name:A
Last Name:ISAENKO
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 1:838 STATE FARM RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-265-4845
Mailing Address - Fax:
Practice Address - Street 1:838 STATE FARM RD. UNIT 1
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-355-9858
Practice Address - Fax:828-355-9859
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor