Individual
ALEXANDRA DEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 HICKORY RD, HOLLY SPRINGS, GA 30115-9600
(678) 880-6616
Mailing address
120 HICKORY RD, HOLLY SPRINGS, GA 30115-9600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010248
GA
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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