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General NPI Number Information
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NPI Number | 1164615449
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Entity Type | Organization
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Legal Business Name | ALEXANDRIA SPINE & REHAB CENTER LLC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 1133 MACARTHUR DR STE. B
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3123
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Country | US
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Telephone | 318-561-6250
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Fax | 318-561-6252
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Provider Business Mailing Address
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Address Line | 1133 MACARTHUR DR STE. B
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3123
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Country | US
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Telephone | 318-561-6250
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Fax | 318-561-6252
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. BRADLEY F KIRZNER
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Credential | DC
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Telephone | 318-561-6250
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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 | 1339
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License Number State | LA
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