Healthcare Provider Details

I. General information

NPI: 1215849468
Provider Name (Legal Business Name): ALEXANDER ISOLA CPSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 7TH AVE S
ESCANABA MI
49829-1176
US

IV. Provider business mailing address

2500 7TH AVE S
ESCANABA MI
49829-1176
US

V. Phone/Fax

Practice location:
  • Phone: 906-233-1322
  • Fax:
Mailing address:
  • Phone: 906-233-1322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: