Provider Demographics
NPI:1841622891
Name:WALDECK, ALEX JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:JAMES
Last Name:WALDECK
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 1:2349 DANVILLE RD SW
Mailing Address - Street 2:210
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-4284
Mailing Address - Country:US
Mailing Address - Phone:256-822-1010
Mailing Address - Fax:
Practice Address - Street 1:2349 DANVILLE RD SW
Practice Address - Street 2:210
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4284
Practice Address - Country:US
Practice Address - Phone:256-822-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor