Provider Demographics
NPI:1659709053
Name:JOSEPH, ALEXANDRA TANLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:TANLEY
Last Name:JOSEPH
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 1:4929 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-4813
Mailing Address - Country:US
Mailing Address - Phone:813-269-0020
Mailing Address - Fax:813-448-1025
Practice Address - Street 1:4929 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-4813
Practice Address - Country:US
Practice Address - Phone:813-269-0020
Practice Address - Fax:813-448-1025
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor