Healthcare Provider Details

I. General information

NPI: 1144910233
Provider Name (Legal Business Name): ALEJANDRA SAUCEDO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5605 W FRIENDLY AVE STE G
GREENSBORO NC
27410-4253
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 336-617-0277
  • Fax: 336-617-0334
Mailing address:
  • Phone: 423-541-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP22202
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: