Provider Demographics
NPI:1841922416
Name:PAUL, ALEXANDRA ALISE (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:ALISE
Last Name:PAUL
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 1:1390 COVENTRY LN APT 2
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3088
Mailing Address - Country:US
Mailing Address - Phone:908-566-6336
Mailing Address - Fax:
Practice Address - Street 1:13900 7TH ST
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:WI
Practice Address - Zip Code:54758-7401
Practice Address - Country:US
Practice Address - Phone:715-530-4080
Practice Address - Fax:833-922-1075
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor