Provider Information for 1306397997
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ALEXANDRA SHAY IRISH
Sex: Female
NPI: 1306397997
Last Updated: 2024-05-21
Certification Date: 2024-05-21
Certification Date: 2024-05-21
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1306397997 | ||||||||||||||||
| Enumeration Date | 2016-10-18 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1300 N 17TH AVE GREELEY, CO 80631-9584 United States Phone: 970-347-2120 | Fax: | ||||||||||||||||
| Primary Practice Address | 1300 N 17TH AVE GREELEY, CO 80631-9584 United States Phone: 970-347-2120 | Fax: | ||||||||||||||||
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