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General NPI Number Information
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NPI Number | 1982408274
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Entity Type | Individual
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Provider Name | ALEXANDRA MARIE WING-LACLAIRE DC
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Gender |
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 101 CLEMENT ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2419
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Country | US
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Telephone | 415-497-0130
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Fax |
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Provider Business Mailing Address
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Address Line | 295 8TH AVE APT 3
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2596
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Country | US
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Telephone | 413-834-0634
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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 | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | RHC00207972
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | DC36831
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License Number State | CA
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