Provider Demographics
NPI:1497779060
Name:KRISCHANOWSKI, ALEX GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:GREGORY
Last Name:KRISCHANOWSKI
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 1:3467 PINE RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3832
Mailing Address - Country:US
Mailing Address - Phone:239-592-5367
Mailing Address - Fax:239-592-5048
Practice Address - Street 1:3467 PINE RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3832
Practice Address - Country:US
Practice Address - Phone:239-592-5367
Practice Address - Fax:239-592-5048
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU95500Medicare UPIN
FL76968Medicare PIN