Healthcare Provider Details

I. General information

NPI: 1154258648
Provider Name (Legal Business Name): ALEXIS LAMAR NOWELL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

3311 JESSIE VILLAGE DR
CLEMMONS NC
27012-9963
US

IV. Provider business mailing address

2711 FOUR SEASONS BLVD APT H
GREENSBORO NC
27407-6060
US

V. Phone/Fax

Practice location:
  • Phone: 336-659-4135
  • Fax:
Mailing address:
  • Phone: 540-290-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24878
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: