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General NPI Number Information
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NPI Number | 1003390899
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Entity Type | Individual
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Provider Name | ALEXANDRA VALDIVIEZO DC
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Gender | Female
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 700 COMMERCE DR STE 260
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City | WOODBURY
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State | MN
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Zip | 55125-9243
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Country | US
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Telephone | 651-330-9453
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Fax |
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Provider Business Mailing Address
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Address Line | 700 COMMERCE DR STE 260
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City | WOODBURY
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State | MN
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Zip | 55125-9243
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Country | US
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Telephone | 651-330-9453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7245
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.013264
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License Number State | IL
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