Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 038.012819 | IL |
NPI | 1043693575 |
---|---|
Provider Name | Dr. Alexander E Earl |
First Address | Batavia, IL 60510-1627 |
Second Address | Batavia, IL 60510-1627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2015 |
Last Update Date | 01/07/2015 |