Individual provider · Type 1 NPI
Alexander Anton Provost, DC
Chiropractor · Shawano, WI
NPI number
1306434337
Active
Practice location
W5675 County Road B
Shawano, WI 54166-6901
Mailing address
8732 Polk St NE
Blaine, MN 55434-2346
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor | 111N00000X | 6646 (MN) |
| Chiropractor Primary | 111N00000X | 5599-12 (WI) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Another provider at this address
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About NPI 1306434337
Alexander Anton Provost, DC's National Provider Identifier is 1306434337, issued on Jan 5, 2021. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Shawano, WI. The record was last updated on Jan 5, 2021.