Provider Demographics
NPI:1013720226
Name:KENT, ALEXA ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:ELIZABETH
Last Name:KENT
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 1:1335 FLEMING AVE LOT 222
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8253
Mailing Address - Country:US
Mailing Address - Phone:518-867-7163
Mailing Address - Fax:
Practice Address - Street 1:1616 JORK RD STE 302
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2494
Practice Address - Country:US
Practice Address - Phone:904-437-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor