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NPI Code Detail

MEDICARE: MR. ROBERT CHARLES ALEXANDER OTR

MEDICARE: MR. ROBERT CHARLES ALEXANDER OTR
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
1225X00000XOccupational Therapist1241-026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700059573
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT CHARLES ALEXANDER OTR
Provider Business Mailing Address
First Line : 2801 15TH AVE
Second Line :
City : SOUTH MILWAUKEE
State : WI
Zip : 53172-3029
Country : US
Telephone Number : 414-571-0010
Fax Number :
Provider Business Practice Location Address
First Line : 3100 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-1604
Country : US
Telephone Number : 262-658-4622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2008
Last Update Date : 04/11/2008

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