Healthcare Provider Details

I. General information

NPI: 1902717085
Provider Name (Legal Business Name): ALEXIS ROSE TODD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 UNITYPOINT WAY STE 70
MARSHALLTOWN IA
50158-4749
US

IV. Provider business mailing address

6623 DEERPATH RD
LAKE GENEVA WI
53147-3691
US

V. Phone/Fax

Practice location:
  • Phone: 641-754-6120
  • Fax:
Mailing address:
  • Phone: 262-903-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17911-24
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP062198T
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: