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Individual

ALEXANDER CLABOURNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RDN

Contact information

Practice address
20440 N 27TH AVE, PHOENIX, AZ 85027-3240
(480) 882-4545
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
(480) 882-5814

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86276869
AZ
133V00000X
Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122743
AZ
Enumeration date
09/13/2021
Last updated
12/22/2022
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