Provider Demographics
NPI:1700345402
Name:BURKHARDT, ALEXIS MARTI (DC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARTI
Last Name:BURKHARDT
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 1:1125 E SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1809
Mailing Address - Country:US
Mailing Address - Phone:231-830-1111
Mailing Address - Fax:
Practice Address - Street 1:1125 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-1809
Practice Address - Country:US
Practice Address - Phone:231-830-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230101078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor