Healthcare Provider Details

I. General information

NPI: 1962949347
Provider Name (Legal Business Name): ALEXA LYNN KUZDAL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXA SCHWEIGER DPT

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32743 23 MILE RD STE 220
CHESTERFIELD MI
48047-2176
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TOWNSHIP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 586-648-5050
  • Fax: 586-648-5051
Mailing address:
  • Phone: 586-350-2644
  • Fax: 586-541-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501018036
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: