Healthcare Provider Details

I. General information

NPI: 1467798538
Provider Name (Legal Business Name): MAXHEALTH MOBILE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 15TH ST W 235
DICKINSON ND
58601-3017
US

IV. Provider business mailing address

116 SOUTH RD
DEERFIELD NH
03037-1709
US

V. Phone/Fax

Practice location:
  • Phone: 702-630-1055
  • Fax: 603-463-1229
Mailing address:
  • Phone: 603-463-1229
  • Fax: 603-463-1229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number888
License Number StateND

VIII. Authorized Official

Name: DR. STEPHEN A ALEXANDER
Title or Position: OWNER
Credential: DC
Phone: 702-630-1055