Provider Demographics
NPI:1174935373
Name:ISON, ALEXANDER SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:SCOTT
Last Name:ISON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 CLEVELAND HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1215
Mailing Address - Country:US
Mailing Address - Phone:863-646-5707
Mailing Address - Fax:863-647-5044
Practice Address - Street 1:3740 CLEVELAND HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1215
Practice Address - Country:US
Practice Address - Phone:863-646-5707
Practice Address - Fax:863-647-5044
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor