Provider Demographics
NPI:1578224200
Name:MCHUGH, ALEXANDER M (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:M
Last Name:MCHUGH
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 1:344 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MAYER
Mailing Address - State:MN
Mailing Address - Zip Code:55360-9603
Mailing Address - Country:US
Mailing Address - Phone:612-205-5947
Mailing Address - Fax:
Practice Address - Street 1:1309 OAK AVE STE 207
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1080
Practice Address - Country:US
Practice Address - Phone:952-466-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6938OtherSTATE LICENSE