Provider Demographics
NPI:1851907307
Name:PERRY, ALEXANDREA KASAP (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:KASAP
Last Name:PERRY
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:EARLHAM
Mailing Address - State:IA
Mailing Address - Zip Code:50072-0073
Mailing Address - Country:US
Mailing Address - Phone:515-805-7619
Mailing Address - Fax:
Practice Address - Street 1:115 W 1ST STREET
Practice Address - Street 2:
Practice Address - City:EARLHAM
Practice Address - State:IA
Practice Address - Zip Code:50072
Practice Address - Country:US
Practice Address - Phone:515-805-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2067111N00000X
IA115521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty