Provider Demographics
NPI:1376258442
Name:OBERNAUER, ALEXANDRIA MERCEDES (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:MERCEDES
Last Name:OBERNAUER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDDLEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7054
Mailing Address - Country:US
Mailing Address - Phone:814-724-9215
Mailing Address - Fax:
Practice Address - Street 1:140 SAGE CREEK WAY
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0957
Practice Address - Country:US
Practice Address - Phone:865-848-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor