Provider Demographics
NPI:1053166884
Name:COLE, ALEXANDRIA (DC)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:COLE
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 1:1015 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-9189
Mailing Address - Country:US
Mailing Address - Phone:270-452-2187
Mailing Address - Fax:
Practice Address - Street 1:1015 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9189
Practice Address - Country:US
Practice Address - Phone:270-452-2187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY289975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor