Alexandra Modell, L.Ac.
Acupuncturist in Glendale, WI. Individual provider (NPI-1).
NPI number1063043875
StatusActive
Last updated in NPPESJan 30, 2020
Details
- NPI
- 1063043875
- Entity type
- Individual (NPI-1)
- Name
- Alexandra Modell
- Credential
- L.Ac.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 30, 2020
- Certification date
- Jan 30, 2020
- Last updated
- Jan 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171100000X | Acupuncturist | 948-55 | WI | Yes |
Practice location
5225 N Ironwood Rd Ste 102Glendale, WI 53217-4909
Phone 414-491-2084
Mailing address
5225 N Ironwood Rd Ste 102Glendale, WI 53217-4909
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