Healthcare Provider Details

I. General information

NPI: 1730988817
Provider Name (Legal Business Name): ALEX PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 NORTHSIDE DR SUITE 200
ALEXANDRIA MN
56308-5578
US

IV. Provider business mailing address

591 NORTHSIDE DR SUITE 200
ALEXANDRIA MN
56308-5578
US

V. Phone/Fax

Practice location:
  • Phone: 320-445-0100
  • Fax: 320-445-0098
Mailing address:
  • Phone: 320-445-0100
  • Fax: 320-445-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JACOB CRUZE
Title or Position: CO-OWNER
Credential: DPT
Phone: 651-283-6894