Individual
MR. ALEX KEITH BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 SANCTUARY LN, COLUMBIANA, AL 35051-5435
(205) 259-6245
Mailing address
CMR 467 BOX 5194, APO, AE 09096-1052
(619) 333-8368
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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