Healthcare Provider Details

I. General information

NPI: 1912747270
Provider Name (Legal Business Name): ALEXANDER MARETT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 HUSKY DR
WINTERSET IA
50273-2281
US

IV. Provider business mailing address

1660 MARELLA TRL
DES MOINES IA
50310-3820
US

V. Phone/Fax

Practice location:
  • Phone: 515-462-3320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: