Provider Demographics
NPI:1134235005
Name:ALEXANDER, BLAIR T (DC DABCO)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:T
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DC DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3800 WYOMING BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3205
Mailing Address - Country:US
Mailing Address - Phone:505-296-1639
Mailing Address - Fax:505-296-5610
Practice Address - Street 1:3800 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3205
Practice Address - Country:US
Practice Address - Phone:505-296-1639
Practice Address - Fax:505-296-5610
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1179111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic