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NPI Code Detail

MEDICARE: MRS. DEBORAH SUSAN ALEXANDER PT

MEDICARE: MRS. DEBORAH SUSAN ALEXANDER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501001675MI

General Provider Information

NPI Number : 1336155407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH SUSAN ALEXANDER PT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2700 ORCHARD LAKE RD
Second Line :
City : KEEGO HARBOR
State : MI
Zip : 48320-1445
Country : US
Telephone Number : 248-683-0185
Fax Number : 248-683-5692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/11/2014

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