Healthcare Provider Details

I. General information

NPI: 1508275595
Provider Name (Legal Business Name): ALEXANDRIA CARICO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA TAMPOW

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S KIRKWOOD RD STE 201
KIRKWOOD MO
63122-6161
US

IV. Provider business mailing address

14450 S OUTER 40 RD
CHESTERFIELD MO
63017-5711
US

V. Phone/Fax

Practice location:
  • Phone: 314-909-4848
  • Fax: 314-909-4824
Mailing address:
  • Phone: 314-434-6060
  • Fax: 314-434-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: