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NPI Code Detail

MEDICARE: ALIXANDRIA DESPAIN

MEDICARE: ALIXANDRIA DESPAIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist

General Provider Information

NPI Number : 1457186660
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIXANDRIA DESPAIN
Provider Business Mailing Address
First Line : 140 STILLWATER DR
Second Line :
City : BEREA
State : KY
Zip : 40403-7002
Country : US
Telephone Number : 270-823-2244
Fax Number :
Provider Business Practice Location Address
First Line : 124 KENTUCKY AVE
Second Line :
City : LEXINGTON
State : KY
Zip : 40502-1755
Country : US
Telephone Number : 270-823-2244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2024
Last Update Date : 09/06/2024

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Directions to “ ALIXANDRIA DESPAIN ” Practice Location

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