Healthcare Provider Details

I. General information

NPI: 1184339889
Provider Name (Legal Business Name): ALEXANDRIA NICOLE HOVIS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 01/17/2023
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12642 VICTORIA HTS
FESTUS MO
63028-3854
US

IV. Provider business mailing address

12642 VICTORIA HTS
FESTUS MO
63028-3854
US

V. Phone/Fax

Practice location:
  • Phone: 636-232-4152
  • Fax:
Mailing address:
  • Phone: 636-232-4152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2022049400
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: