Provider Demographics
NPI:1942341771
Name:REJISTRE, ALEXANDER ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:ASHLEY
Last Name:REJISTRE
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 1:121O WEST 5 AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601
Mailing Address - Country:US
Mailing Address - Phone:870-536-9060
Mailing Address - Fax:870-536-4548
Practice Address - Street 1:121O WEST 5 AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601
Practice Address - Country:US
Practice Address - Phone:870-536-9060
Practice Address - Fax:870-536-4548
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor