Provider Demographics
NPI:1477631729
Name:LY, ALEXANDER M (MS, CMD, CA)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:M
Last Name:LY
Suffix:
Gender:M
Credentials:MS, CMD, CA
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2155 LIME KILN RD
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-4644
Mailing Address - Country:US
Mailing Address - Phone:256-446-6607
Mailing Address - Fax:256-446-6666
Practice Address - Street 1:2155 LIME KILN RD
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-4644
Practice Address - Country:US
Practice Address - Phone:256-446-6607
Practice Address - Fax:256-446-6666
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist